Register - Advanced Dental Administration

Please use this Registration page for Venue meeting registration only.

Contact us to register for In-Office Training.

Registration

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Dental Practice Name (Type NONE if currently looking for a position)(Required)

Dental Practice Phone Number (Your number if currently looking for a position)(Required)

Your Position(Required)

Course Date(Required)

Course Location(Required)

Dental Office Administration Course(Required)

Price:

Credit Card(Required)

Total

Comments

This field is for validation purposes and should be left unchanged.

YOU MAY SUBMIT PAYMENT NOW BY CREDIT CARD WITH YOUR REGISTRATION OR YOU MAY PRINT THE REGISTRATION FORM AND MAIL WITH YOUR CHECK TO:

ADVANCED DENTAL ADMINISTRATION
204 SCOTT LN.
KINGSTON, TN 37763

If submitting by mail, be sure to allow sufficient time for snail mail to arrive 2 weeks prior to the course date.

Refund in full will be given if registration is canceled 30 days prior to course date.

Refund at 50% will be given if registration is canceled from 30 days to 14 days prior to course date.

No refund will be given if registration is canceled after 2 weeks prior to course date.

PAYMENT IS DUE IN FULL 2 WEEKS PRIOR TO COURSE BY CHECK OR CREDIT CARD.

ALL REFUND REQUESTS AND CANCELATIONS MUST BE BY EMAIL AT contact@advanceddentaladmin.com.