Join us for a Dental Continuing Education seminar in your area!

SGS Seminar Pricing:
DOCTOR: $995
STAFF: $395
(Write any special pricing offer you received in the comments box and your registration will be processed with the promotion you mention)

Once submitted your order will be processed by SGS. You will receive a confirmation via email once your registration has been processed and paid.

Seminar Registration
Your name *
Email address *
Office Phone Number *
Mobile Phone Number
Fax Number
Address *
Address 2
City, State ZIP *
Which Seminar Would You Like to Attend? *
How Did You Hear About This Seminar? *
Did you receive a coupon code or special pricing offer? Please enter it here:
Name of Doctor(s) Attending *
AGD Member # (For AGD PACE CE Credits)
Name of Staff Member(s) Attending
Attach a picture of the doctor for name tags. (Optional)
Credit Card Payment *    
Credit Card Number *
Card Expiration Date *
Security Code (3 Digits on back of card) *
Billing Address/Phone Same as Above? *   
If Billing Address is Different Please Provide Below
Comments / Notes for SGS
 
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