Registration form

Which course do you want to register for? *

Attendee Details

What is your Clinical Specialty? *

How many implants have you placed? *

How Did You Hear About This Event? *

Policy Agreement *

We are committed to protecting your privacy at Camarlengo Dental Institute. We will not collect any personal information from you that you do not volunteer, and we are the sole owner of all information collected on this site. We do not sell, share, or rent this information to others in any way that we have not mentioned in this statement.

By submitting your Registration you accept our Terms & Privacy Policy.

BY FILLING OUT THIS REGISTRATION FORM, YOU ARE NOT ENROLLED IN THIS COURSE. NOR WILL PAYMENT BE RECEIVED UNTIL FIRST YOUR REGISTRATION REQUEST IS REVIEWED AND AN ACADEMIC INTERVIEW IS SCHEDULED WITH OUR DIRECTOR TO GO OVER YOUR SURGICAL SKILLSET LEVEL AND COURSE CRITERIA.

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Clinical Training Center (USA)

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