Δ To finish your registration, please fill out the form below. Add me to the waitlist!Your InformationThis field is hidden when viewing the formSelect Dates(Required) Call for dates! Name First Last Practice NamePhoneEmail Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Is your practice part of a DSO (Dental Service Organization)? Yes No Have you attended any of our courses or lectures? Yes No Have you ever worked with a practice management firm? Yes No Practice GoalsAre you a Mari's List member? Yes No Whom may we thank for referring you to our Workshop? Mailer Internet Other Please SpecifyAttendeesAttendeesNamePosition Add RemoveClick the (+) icon to add additional attendees.Tuition Policy: The tuition is nonrefundable 30 days prior to the Workshop. However, tuition may be transferred to the next available Workshop for a fee of $250.00.CAPTCHA
