Registration form 1 Year Clinical Masters Program in Oral Implantology 2015-16 " a 9 Session Course in Lahore"



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REGISTRATION FORM
1 Year Clinical Masters Program in Oral Implantology 2015-16

A 9 Session Course in Lahore”


Name: _________________________________________________________________________________
Age: _________ Qualification: _____________________________________________________________
Office Address: __________________________________________________________________________
Home Address: __________________________________________________________________________
City: ____________________ Post Code: _____________ Office Tel: ___________________________
Home Tel: ________________________Fax ________________ E-mail: __________________________
Mobile: _______________________ Web add: ____________________________________________

COURSE FEE SCHEDULE:

The convenient 5 installments payment plan

1st Installment: May 1

2nd Installment: Jun 12

3rd Installment: Aug 7

4th Installment: Sep 18

Final Installment: Oct 30




  • International Participants: US$ 2500/- (Registration fee US$ 1,000 payable before the registration deadline, followed by 2 easy installments of US$ 750/- each)

  • 30% Discount for House Surgeons & Students (Registration Fee Rs 35, 000 payable before the deadline followed by 5 easy installments of 18,900 each during

first 5 months)

Registration fee enclosed

N.B:

Cheques/Bank Drafts must be made payable to Pakistan Academy of Implant Dentistry.


Please fill in this Registration form before the Registration deadline of April 19, 2015 and mail via courier to:
Pakistan Academy of Implant Dentistry

The Qureshi Dental Centre, 1051-B, LMQ Road, Multan -60700

Phone: 0342 9541923

E-mail: paid.com.pk@gmail.com

Facebook: Pakistan Academy of Implant Dentistry

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Strictly Limited Attendance Course.


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