Academy of Dental Technology by Lindsay Hermsen

Academy of Dental Technology 2010 An Advanced Multidisciplinary Study Club for Dental Technologists 10 Evening Meetings 6:30pm - 9:30pm (dinner included)

13 Full Day & Extended Half Day Meetings 8:00am - 4:30pm, 8:00am - 12:30pm (breakfast & break included)

3 Hands-on Meetings 1 Hands-on Demo Meeting

Formal Education will make you a Livingâ&#x20AC;Ś Self Education will make you a Fortune!

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Thank you to our Sponsors

BioHorizons ______________________ www.biohorizons.com

Dentsply Canada ________________________ www.dentsply.ca

DRM Research Laboratories ________________ www.drmco.com

Micrylium Professional Disinfection _____ www.micrylium.com

MIS Implants Canada Inc. ____________ www.mis-implants.com

Nobel Biocare Canada Inc. __________ www.nobelbiocare.com

Shaw Group of Dental Laboratories ____ www.shawlabgroup.com

Straumann Canada ________________ www.straumann.com

Swiss NF Metals Inc. ____________________ www.swissnf.com

Vident ______________________ www.vident.com

www.AcademyDentalTechnology.com

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2010 ADT Speaker Sessions Monday, January 18, 2010

6:30pm - 9:30pm (Upscale Dinner Included)

ADT Opening Gala: Corporate Mini-Clinics Sponsored by Academy of Dental Technology Audience members are placed in small groups to listen to short presentations by several corporate sponsors. This is a fast paced and very interactive meeting. Attendees will enjoy an up-scale dinner; time to socialize with their fellow ADT members and chances to win free prizes!

Various Speakers Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Monday, January 25th, 2010 Full Spectrum Prosthetics for the Straumann Dental Implant System

6:30pm - 9:30pm (Dinner Included) Hands-on Demo

Sponsored by Straumann Canada This review and hands-on workshop will familiarize participants with the latest cutting edge prosthetic options for users of the Straumann Dental Implant System. Understanding these options will give the dental technician the ability to provide customers a full array of prosthetic solutions: from simple and cost effective posterior restorations to predictable and flexible esthetic restorations. We will also provide and an update on Straumann CADCAM solutions, IPS e.max Abutments, digital impressions and guided surgery solutions.

Vladamir Matovic, Degree in Dental Technology, Territory Manager, Central Region, Straumann CAD/CAM Vladimir has obtained his Dental Technology Degree from George Brown College in 2000. Through his years of education he was directly involved in production of dental appliances with hands on experience about patient care and health promotion. Later on, utilizing the knowledge and experience from lab work, Vladimir has provided technical and business support to labs working with a large Dental manufacturer and supplier from Germany as a Technical Sales Manager. Approach to his job is to ultimately lead the lab owner and operator to the highest levels of performance that will directly benefit the patient and their experience. His previous experience and education in dental profession has assisted Vladimir in understanding Straumann products and service offers to effectively implement them in the dental market since 2007.

Ontario Science Centre - 770 Don Mills Rd., Toronto â&#x20AC;&#x201C; Gemini West Room

Advanced registration required for each session. Call 905.258.0363 or email dentalevents@rogers.com www.AcademyDentalTechnology.com www.AcademyDentalTechnology.com

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Friday, January 29th, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Tissue Compatible Integrated Implant Prosthodontics, Functional-Esthetics Sponsored by DRM Research Laboratories Inc. • Chemical Engineering; microstructural differentiation & functional-aesthetic implications • Biomechanical concepts; comparative analysis - ceramic, amorphous composites, semicrystalline polyglass • Preparation & stratification methodology • Accelerated cyclic-fatigue studies, In-Vivo correlation • Impact, catastrophic fracture studies, clinical implications • Chair side direct / indirect build-up technique(s) • Extra oral cementation vs. integrated abutment crowns • Photo polymerization; material, cure modality and operator failure probability • Halogen, XePlasma, ArLaser, LED • Mechanisms of Adhesion; interfacial bond magnitude, integrity and longevity • Biocompatibility & Cytotoxicity; fibroblasts, blood, muscular and epithelium tissue implant reactivity • Tissue support; bone graft - architectural technology • Performance probability

Dr. Samuel Waknine, M(D.M.S.), Ph.D Alumnus of University of California at Irvine, New York University Dental Center and University of Connecticut Health Center & Institute of Materials Science; Restorative Dentistry & Chemical Engineering dual-Doctorate. Dr. Waknine is an Active Member; International Association for Dental Research, Biomedical Materials Research Congress Society, Academy of Dental Materials, International Society of Electron Microscopy, American Chemical Society, American Institute of Chemists, European Academy of Stomatology, Implantology and Esthetic Dentistry.

Ontario Science Centre - 770 Don Mills Rd., Toronto – Telus Room

Wednesday, February 10, 2010

6:30pm - 9:30pm (Dinner Included)

NobelProcera Sponsored by Nobel Biocare Mr. Larry Rips Larry Qualified as a Dental technician in 1990 in Johannesburg South Africa, After which he worked and studied with one of the Top Technicians in Strasbourg, France. He emigrated to Canada in 1992 and spent 4 years working as a ceramist in a prestigious Downtown Laboratory where he obtained his RDT .In 1998 together with his Partner Alan David RDT they opened A & L Dental Laboratory. They were amongst the very first Laboratories in Canada to fully embrace Cad/Cam Technology and have been involved in Research and development as well as testing new products for various Dental Manufacturers. Larry is one of only a few technicians that have participated in completed a surgical mentorship program in implant dentistry, as well as having completed the Dawson Centres occlusion course amongst others.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

www.AcademyDentalTechnology.com

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Friday, February 12, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Extraction & Immediate Implant Placement Bone Augmentation – The Next Generation Special Aseptic Considerations Sponsored by Micrylium Among the great challenges facing clinical research is the development of bioactive surgical additives regulating inflammation and increasing healing. Indeed, after each intervention, surgeons must face complex tissue remodeling phenomena and the consequences on healing and tissue survival. Every extraction is now an opportunity to prevent adjacent periodontal ligament damage and bone necrosis. Special aseptic considerations will be discussed as related to Implantology and sterilization including new advances in measurement and tracking with Instant read-out Class V integrators and RFID instrument trackers that will reduce exposure risks both biologically and legally. Dean Swift will examine the new vacuum Class B machines that are blossoming in the marketplace. Material presented will be a benefit for the entire staff.

Dean Swift, B.Sc., con. Biochemistry, Microbiology Dean Swift is a Materials Scientist and Educator with special interests in Biofilms and Toxicity. He is an original Fellow of the Academy of Dental Materials, a member of the IADR and Innovator’s Alliance. In addition to being Research Director at Micrylium Laboratories he is also a member of the iDAPT Toronto Rehab Research team.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Telus Room

Monday, February 22, 2010

6:30pm - 9:30pm (Dinner Included)

Poly-Crystalline C & B Technology Sponsored by DRM Research Laboratories Inc. This seminar will highlight the following parameters: • Differentiation: Comparative analysis; • PolyCeram Prosthodontics: Alloyless - Fiberless, Characterization, Processing and Stratification • Implant Superstructures: The lecture will emphasize the following issues: • The physiology of occlusion; composite, ceramic, alloy & polycrystalline nanoceram • Tooth preparation methodology; effects and side effects • Auxiliary materials; contraindications and long-term effects • Color and gloss, value; opacity/translucency and stratification gradients • Polishing materials and techniques • Functional - Aesthetics; materials properties • The success of Implant interfacial osseointegration – transitional vs. immediate loading period and the superstructure macrorigidity vs. microelasticity • Biocompatibility & Cytotoxicity - cellular reactivity, tissue irritation, inflammation and manifestation.

www.AcademyDentalTechnology.com

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Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Friday, February 26, 2010

8:30am - 4:30pm (Breakfast, Breaks & Lunch Included)

Chicago Midwinter Meeting – Spectrum Dialogue Techno-Clinical Trade Show and Continuing Education Event during Chicago Dental Mid-Winter Meeting

Christiano Broseghini, MDT • Marco Beschizza, RDT, MDT • Domenico Cascione, MDT • Lee Culp, CDT • Ernst Hegenbarth, MDT • Dr. Stefan Holst • Luke S. Kahng, CDT • Brian LaSage, MDT • Axel Seeger, MDT • Attilio Sommella, MDT • Dr. douglas Terry • Willie Geller • Claude Sieber Wyndham Chicago, 633 N. St. Clair, Chicago, IL

Friday, March 26, 2009

8:00am - 12:30pm (Breakfast & Breaks Included)

Basic Surgical Principles for Complicated Extractions Sponsored by Shaw Group of Dental Laboratories Minor oral surgery is a common thread to every dental practice. There are general surgical principles which are required to perform almost all oral surgical procedures. It is the ability of the practitioner in performing these procedures that is the limiting factor in proficient delivery of care to their patients. This seminar will focus on the basic surgical principles as they apply to complicated dental extractions ranging from patient evaluation, anaesthesia, instrumentation, anatomy, and the handing of soft and hard tissues of the oral cavity. The application of these principles to other oral surgical procedures including periodontal and endodontic therapy, are also relevant. It is the goal of the presenter to provide participants with a strong knowledge base of basic surgical principles in order to deliver proper patient care.

Reena M. Talwar, DDS PhD FRCD(C) Dr. Reena Talwar is an Oral and Maxillofacial Surgeon and Assistant Professor at the University of Toronto, both in the Faculty of Dentistry (Discipline of Oral & Maxillofacial Surgery and Anaesthesia) and Faculty of Medicine (Department of Anatomy). Her goals are to provide her patients with quality surgical care and her students with sound academic principles.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Telus Room

www.AcademyDentalTechnology.com

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Saturday, March 27, 2010

8:00am - 4:30pm (Breakfast, Breaks & Lunch Included)

Pressing and Layering to Zirconia Sponsored by Swiss NF Metals This course will focus on the complete handling and processing of pressing and layering over zirconia. There will be a hands on demonstration that will give attendees the understanding they need to produce these restorations in their labs. Tony Bulley, CDT, RDT Tony Bulley CDT, RDT successfully completed his apprenticeship in Dental Technology in the early 1980â&#x20AC;&#x2122;s. He studied and worked in London prior to re-locating to California where he held a technical training position for a leading porcelain manufacturer and managed a team of ceramists at a large Laboratory. Since 1990 Tony has lectured and taught hands on courses throughout North America. He dedicates his time to the latest innovations and advances in dental technology.

Seneca College Residence & Conference Centre - 1760 Finch Ave. E., Toronto, ON M2J 5G3

Friday, April 30, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Paradigm shift: Making implant surgery simpler for the general dentist Sponsored by MIS Implants Canada Inc. Each panel member will present a challenging case and present possible treatment options. The audience responses will be solicited by the moderator and discussion by panel members. Completion of final case will then be shown by the presenters.

Dr. Edy Braun Dr. Edy Braun graduated from the University of Toronto in 2001. After he achieved his DDS, he did a general practice residency at Beth Israel Medical Center in Newark, New Jersey followed by residency at Albert Einstein Medical Center in Philadelphia, PA. After these 2 hospital residencies, Dr Braun entered the 3-year Periodontics speciality program at Stony Brook University, State University of New York, graduating in June 2006, and in 2007, he received his Fellowship in Periodontology, FRCD (C). Dr. Edy Braun is an experienced in the full range of periodontal plastic-surgical techniques, including gingival esthetic procedures, bone grafting, sinus augmentation and the placement of osseous integrated implants.

Ontario Science Centre - 770 Don Mills Rd., Toronto â&#x20AC;&#x201C; Telus Room

Advanced registration required for each session. Call 905.258.0363 or email dentalevents@rogers.com www.AcademyDentalTechnology.com

www.AcademyDentalTechnology.com

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Monday, May 3, 2010

6:30pm - 9:30pm (Dinner Included)

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Friday, May 21, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Tissue Compatible Integrated Implant Prosthodontics, Functional-Esthetics Sponsored by DRM Research Laboratories Inc. • Chemical Engineering; microstructural differentiation & functional-aesthetic implications • Biomechanical concepts; comparative analysis - ceramic, amorphous composites, semicrystalline polyglass • Preparation & stratification methodology • Accelerated cyclic-fatigue studies, In-Vivo correlation • Impact, catastrophic fracture studies, clinical implications • Chairside direct / indirect build-up technique(s) • Extraoral cementation vs. integrated abutment crowns • Photopolymerization; material, cure modality and operator failure probability • Halogen, XePlasma, ArLaser, LED • Mechanisms of Adhesion; interfacial bond magnitude, integrity and longevity • Biocompatibility & Cytotoxicity; fibroblasts, blood, muscular and epithelium tissue implant reactivity • Tissue support; bone graft - architectural technology • Performance probability

www.AcademyDentalTechnology.com

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Ontario Science Centre - 770 Don Mills Rd., Toronto - Telus Room

Friday, September 17, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Clinical Solutions with NobelActive Prosthetic Protocol with Hands-on

Hands-on Demo

Sponsored by Nobel Biocare Mavis Hunter Mavis Hunter has been in the dental industry in a marketing capacity for the past 24 years. Her vast range of experience has led her to her current position of Regional Sales Manager for Central Ontario at Nobel Biocare where she has worked since 1999.

Ontario Science Centre - 770 Don Mills Rd., Toronto – Telus Room

Monday, September 27, 2010

6:30pm - 9:30pm (Dinner Included)

Poly-Crystalline C & B Technology Sponsored by DRM Research Laboratories Inc. The lecture will emphasize the following issues: • The physiology of occlusion; composite, ceramic, alloy & polycrystalline nanoceram • Tooth preparation methodology; effects and side effects • Auxiliary materials; contraindications and long-term effects • Color and gloss, value; opacity/translucency and stratification gradients • Polishing materials and techniques • Functional - Aesthetics; materials properties • The success of Implant interfacial osseointegration – transitional vs. immediate loading period and the superstructure macrorigidity vs. microelasticity • Biocompatibility & Cytotoxicity - cellular reactivity, tissue irritation, inflammation and manifestation.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

www.AcademyDentalTechnology.com

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Thursday, October 7, 2010

6:30pm - 9:30pm (Dinner Included)

Partial Dentures: Metal, Vinyl and Acetal Resin Sponsored by Dentsply Canada What constitutes a successful partial denture framework and how you can be sure that is what you get! This Lecture will provide insight into the many applications available today for the fabrication of Partial Denture Restorations. Basic framework design procedures and frameworks with vinyl, acetal resin, and Eclipse VLC base plates will all be presented. Technique demonstrations on FRS, Eclipse base plate and Thermoflex Acetal Resin will be shown including the use of VLC composite (Radica) for individual tooth construction. VLC partials: no wax - no investing - no divesting…participants will also leave with processing tips for distal extension hinges, attachments and implant components.

Clarence Spring, RDT, CDT Clarence Spring is a previous dental laboratory owner and General Manager in the Calgary area; originally registered in the Province of Alberta 1977. He has lectured nationally representing Kavo, Degussa, and Dentsply. He has written and co-authored a number of articles regarding articulation and removable restorations. In his current position as Technical Product Specialist for Dentsply Canada, Clarence’s most recent accomplishments include primary participation in the development of Dentsply EPIC, a continuing education certification program.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Friday, October 8, 2010

8:00am - 4:00pm (Breakfast, Breaks & Lunch Included)

Partial Dentures: Metal, Vinyl and Acetal Resin Sponsored by Dentsply Canada

Hands-on Demo

Hands-on continuation from October 7th, 2010 meeting.

Clarence Spring, RDT, CDT Clarence Spring is a previous dental laboratory owner and General Manager in the Calgary area; originally registered in the Province of Alberta 1977.He has lectured nationally representing Kavo, Degussa, and Dentsply. He has written and co-authored a number of articles regarding articulation and removable restorations. In his current position as Technical Product Specialist for Dentsply Canada, Clarence’s most recent accomplishments include primary participation in the development of Dentsply EPIC, a continuing education certification program.

Central Dental Ltd., 3420 Pharmacy Ave., Unit 3, Scarborough, ON M1W 2P7

Advanced registration required for each session. Call 905.258.0363 or email dentalevents@rogers.com www.AcademyDentalTechnology.com

www.AcademyDentalTechnology.com

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11/24/2009 3:45:00 PM

Friday & Saturday, October 15-16, 2010

9:00am - 4:30pm (Breakfast, Breaks & Lunch Included)

11th Annual International Dental Congress Register at 905.258.0363 or dentalevents@rogers.com Techno-Clinical Trade Show and Speaker Sessions. Free admission for all ADT members. Must preregister! Visit www.internationaldentalcongress.com for full event listings.

Sheraton Toronto Airport Hotel & Conference Centre, 801 Dixon Rd. Toronto

Wednesday, October 20, 2010

6:30pm - 9:30pm (Dinner Included)

Attachment Problems & Solutions Sponsored by Swiss NF Metals This seminar will feature numerous problems and their solutions for both simple and complex attachment cases. You will learn the basic parameters for working with Intra-Coronal as well as Extra-Coronal attachments.

Peter E. Staubli, MDT, CDT Peter Staubli graduated top of his class in 1964 from a 4 year program at the Swiss Dental Technology School in Zurich, Switzerland. He then worked for two laboratories that were owned by the presidents of the Board of Dental Examiners. He has 42 years of experience and expertise in the dental technology field, with 36 of those years specializing in Attachments and Dental Implants. He has lectured extensively in Europe, Mexico, Asia, Canada and the United States on milling, case design, implant and attachment reconstruction’s. Currently, he holds a seat on the Board of Directors of the American Foundation For Attachment and Implant Research. This board dedicates itself in continuing research to improve the education of those in the attachment and dental implant field.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Thursday, November 18, 2010

6:30pm - 9:30pm (Dinner Included)

The physiology of occlusion; composite, ceramic, alloy & polycrystalline nanoceram Tooth preparation methodology; effects and side effects Auxiliary materials; contraindications and long-term effects Color and gloss, value; opacity/translucency and stratification gradients Polishing materials and techniques Functional - Aesthetics; materials properties www.AcademyDentalTechnology.com

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• The success of Implant interfacial osseointegration – transitional vs. immediate loading period and the superstructure macrorigidity vs. microelasticity • Biocompatibility & Cytotoxicity - cellular reactivity, tissue irritation, inflammation and manifestation.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Friday, November 26, 2010

8:00am - 12:30pm (Breakfast & Breaks Included)

Current Dental Implant Designs: A Market Comparison Sponsored by BioHorizons This lecture will examine current implant systems in the Canadian marketplace. It will include a brief history on each major implant company and how these companies and their implant designs have evolved in a short period of time.

Nello Matarazzo, General Manager, BioHorizons Canada Mr. Nello Matarazzo is the General Manager for BioHorizons Canada and is also the Director for the Misch International Implant Institute® Canada.

Mark LoPresti, National Sales Manager, BioHorizons Canada Mr. Mark LoPresti is the National Sales Manager for BioHorizons Canada and has been with the company for the past five years.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Telus Room

Monday, December 1, 2010

6:30pm - 9:30pm (Dinner Included)

Technologists to Technologist: Mini Clinic Presentations Sponsored by Academy of Dental Technology Audience members are placed in small groups to listen to short presentations by several fellow RDTs ad Technicians. This is a fast paced and very interactive meeting.

Various Speakers Ontario Science Centre - 770 Don Mills Rd., Toronto - Gemini West Room

Advanced registration required for each session. Call 905.258.0363 or email dentalevents@rogers.com www.AcademyDentalTechnology.com

www.AcademyDentalTechnology.com

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Friday, December 17, 2010

8:00am - 4:30pm (Breakfast, Breaks & Lunch Included)

Esthetics and Materials: What? Where? When? Sponsored by Vident The presentation will cover the current research about the efficacy and clinical success of these new materials from simple treatments such as bleaching to more involved fixed partial denture to implant situations. Specific clinical indications for these various materials will be given based on the research and clinical evidence from ongoing clinical trials. Guidelines will be detailed that will help the practitioner to decide when to inlay vs. onlay, when to onlay vs. crown, when to direct bond vs. indirect veneer, and when and what material is indicated for fixed partial dentures. Indications and design requirements for clinical success with metal free alternatives will be featured. Attention will be given to preparation requirements, tissue management, impressions, provisionalization, shade matching and cementation using several clinical examples. Topics Covered: • How material physical properties relate to clinical success and failure • A systematic approach to indirect material selection • When to use a “Etchable” ceramic restoration e.g. bonded porcelain • When to veneer vs. when to crown • When to do no-prep veneers • When, why, and how to remove tooth structure for various types of materials and differing clinical conditions • When to inlay vs. onlay • Clinical management of several clinical cases covering all types of indirect restorations

Edward McLaren, DDS Dr. McLaren is a Prosthodontist and ceramist, he has written over 25 articles on his technique and research related topics. He is currently the director of the UCLA Center for Esthetic Dentistry and provides a full time residency in esthetic dentistry and also mini residencies for practicing dentists. He is also director of the UCLA School for Esthetic Dental Design, which provides full time and mini residency programs for lab technicians.

Ontario Science Centre - 770 Don Mills Rd., Toronto - Telus

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www.AcademyDentalTechnology.com

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Membership Details Full ADT Membership 2010:

Condensed Membership 2010:

$625.00+GST (previous members) or $725.00+GST (new members) • • • • • • • •

•

$400.00+GST • Access to a Maximum of 6 Educational Seminars • Reduced Rate on Health Series

10 Evening Meetings 12 Full/Extended Half Day Meetings 4 Hands-on/Demo Meetings Free access to Spectrum Dialogue TechnoClinical Day in Chicago, IL (Value of $200.00) Free Admission to the International Dental Congress 2010. Value of $199.00 Free subscription to TeamWork Magazine. Value of $146.00 Free Access to www.dentalvideos.us – online Dental Education Seminars 50% Discount to Dental Labor. Correspondence learning worth CE points! Value of $50.00 Group Rate Applies – See Details on Registration Form

Transferable Membership *NEW: $650.00+GST (previous members) or $750.00+GST (new members) • Members can choose to share their ADT seminar admission with other colleagues • Must provide all names of those they would like to distribute their membership with • Membership only allows for 1 person from each transferrable membership to attend each seminar. • If more then one person from each transferrable membership wishes to attend the same course they are subject to a fee of $59.00/ person.

Jurisprudence & Ethics Academy of Dental Technology

•

Jurisprudence & Ethics Program

Coming in 2010! All ADT members will receive a discount to the course fee. To register and if you have any questions please contact: 905.258.0363 or email dentalevents@rogers.com

www.AcademyDentalTechnology.com

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2010 ADT Registration Form   Full Membership 2010:

  Condensed Membership:

  $625.00 + GST = $656.25 (previous members) or   $725.00 + GST = $761.25 (new members)

  $400.00 + GST (maximum 6 seminars only)

  Transferrable Membership:   $650.00 + GST = $682.50 (previous members) or   $750.00 + GST = $787.50 (new members) *Allows you to share your membership with other members of your lab. Only 1 person on this membership is able to attend each seminar. Must provide all names of those eligible to attend seminars on this form.

  Group Rates:   2 - 5 RDTs/Technicians........10% Discount per person   6 - 10 RDTs/Technicians...... 15% Discount per person   11+ RDTs/Technicians.......... 20% Discount per person *Must be from the same Laboratory to qualify for group discount rate

Registration Information:

(Select type of membership for each name)

 Full

 Condensed

 Transferrable

Mr. Ms. ______________________________________________________________________________ RDT? (circle one)

 Full

First Name

 Condensed

Last Name

(check one)

 Transferrable

Mr. Ms. ______________________________________________________________________________ RDT? (circle one)

 Full

First Name

 Condensed

Last Name

 Transferrable

(circle one)

First Name

 Condensed

 Yes  No (check one)

Mr. Ms. ______________________________________________________________________________ RDT?

 Full

 Yes  No

Last Name

 Yes  No (check one)

 Transferrable

Mr. Ms. ______________________________________________________________________________ RDT? (circle one)

First Name

Last Name

 Yes  No (check one)

Laboratory Name: __________________________________________________________________________________ Address: ________________________________________________________________________________________

City: _________________________ Prov.: _____________________ Postal Code: _______________________ Phone: _______________________ Email (mandatory): _____________________________________________

Payment Information:  Cheque (Payable to the Academy of Dental Technology)

 VISA

 MasterCard

Amount Authorized: _________________________________________________________________________ Card Number: _________________________________________________________ Exp. Date: ____________ Card Holder Name: ____________________________________ Signature: _____________________________ Mail Registration to: Academy of Dental Technology - 35-145 Royal Crest Court, Markham, ON L3R 9Z4 Fax Registration to: (905) 489-1971 • Email Registration to: dentalevents@rogers.com Questions? Call: (905) 258-0363 • Email: dentalevents@rogers.com • Website: www.academydentaltechnology.com

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Earn CE Points at Every Meeting! ADT Member Benefits: e for the CDTO • Reduced Rat prudence & Approved Juris Ethics Course e for all Health • Reduced Rat es Series of Lectur ional on to the Internat • FREE Admissi (Must pre-register) Dental Congress on to Spectrum • FREE Admissi ay in Chicago Techno-Clinical D r)

(Must pre-registe

ork iption to TeamW • FREE Subscr Magazine s dditional Meeting • Updates & A fered throughout and Bonuses of ail updates. the year! Check em

Academy of Dental Technology 35-145 Royal Crest Court, Markham, ON, L3R 9Z4 T: 905.258.0363 • F: 905.489.1971 E: dentalevents@rogers.com • www.academydentaltechnology.com

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