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Continuing Dental Education


Course Pre-Registration (Step 1 of 5)


COURSE INFORMATION

Course Code: 14-AC-001
Course Title: Comprehensive Mannequin-Based Board Examination Prep Course: A Hands-on Review
Course Date: January 31, 2014
Special Offer: Special Rates are available for individual sessions. Call 919-537-3400 for more information!
 

YOUR REGISTRATION INFORMATION

Your First Name:*
Your Middle Name:
Your Last Name:*
Suffix: Jr.    Sr.
Preferred Name:*
Occupation:* Dentist ($1,496.00)

Would you like to take advantage of the special offer?
yes no
Sex: Male    Female
Is this your 1st time registering for a course?
yes no
Do you have a disability or special need?
yes no
Do you need to register additional people?
If so, how many?