F.I.T. Orlando Course Course Registration Form

Advanced Implant Techniques for Compromised Sites

Cadaver-Base Surgical Training, Orlando, FL
Attendee Information
Name

First NameLast Name
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example@example.com
Phone Number
Format: (000) 000-0000.
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Street Address

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Which hand is your favorite?
Dental Information
Dental License Number
State of Dental License
Owner or Associate
Dental Practice Name
Practice Address

Street Address

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Practice Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Have you taken any implant courses in the past? If so, which one(s)?
whether it was an online, lecture only, hands-on live patient course, etc
I have placed this many dental implants
What implant system (if any) are you currently using?
What are the goals that you are wanting to achieve by taking this course?
Any special considerations needed? (i.e. Food Allergies, Learning Disabilities, etc)
How did you hear about F.I.T.?
Payment
Which Course Date Would You Like To Attend
By checking this box, you acknowledge and agree to the cancellation policy: Cancellations made more than 31 days prior to the scheduled course date are eligible for a full refund or can put toward a future course date. Cancellations made within 31 days of the course date will incur a non-refundable fee of $1,000. If you reschedule your registration and subsequently cancel, the $1,000 non-refundable fee will still apply, regardless of when the cancellation occurs.

Course Tuition

Advanced Implant Techniques for Compromised Sites: Early Bird Pricing LIMITED TO THE FIRST 10 SPOTS

Early Bird Pricing LIMITED TO THE FIRST 10 SPOTS

$4,495.00

Advanced Implant Techniques for Compromised Sites

ADI, 7901 Kingspointe Pkwy Ste 1, Orlando, FL 32819

$4,995.00

F.I.T. Alumni Discount

$195 deposit required, contact F.I.T. for link to pay $4,000 remaining balance after alumni verification. It will be texted/emailed directly. After payment, registration will be activated. If no link/payment completed, registration will not be active and you will not be admitted into the facility.

$4,195

$195.00

Total

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Advanced Implant Techniques for Compromised Sites

Attendee Information

Dental Information

Payment

Course Tuition*

Course Tuition