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Exclusion zone To give the identity a place of prominence, the exclusion zone demonstrated must be applied around the logo Area of exclusion This is the distance from other items positioned close by. Create a square starting at the top left, and finishing at the bottom right. This will be the amount of space around the logo that cannot be encrouched.

Congress logo The Annual World Dental Congress has its own logo of which the “bar” design changes each year with the new host city; see example from 2005. For more information, please see Instructions for the use of the FDI name and logo

Logo variations, see reverse.

PERIIMPLANTITIS ICOI WORLD CONGRESS XXXVI September 27-29, 2018 Bellagio Hotel | Las Vegas, Nevada Young Implantologists Program and Pre-Congress Courses on 27 September

ICOI is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from April 1, 2014 to March 31, 2018. Provider ID# 217378.

ICOI is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorseindividual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about CE provider may be directed to the provider or to ADA CERP at www.ada.org/cerp.

REGISTRATION FORM

ICOI WORLD CONGRESS XXXVI September 27-29, 2018 • Las Vegas, Nevada

Young Implantologists Program and Pre-Congress Courses on September 27th

ICOI ID#

Family Name (Surname) - Please print or type

First Name - Please print or type

Street Address State/Province

City Phone

Zip Code

Country AGD#

E-Mail

REGISTRATION FEES

METHOD OF PAYMENT

SCIENTIFIC SESSION Registration includes scientific session only. It does not include Pre-Congress Courses, Auxiliary or Accompanying Persons programs.

TOTAL AMOUNT USD: $ Cancellation Policy:

On/Before July 12, 2018

After July 12, 2018

$775

$875

ICOI Member

$925

$1025

Non-Member

Laboratory Technician:

$350

$380

ICOI Member

$450

$480

Non-Member

50% of registration fee will be refunded if requested on or before August 1, 2018. Cancellations after this date are nonrefundable. Anyone requesting a refund must complete a Refund Request Form. Please contact thecentral office via email at [email protected].

Full-Time Faculty:

$375

$410

ICOI Member

THREE WAYS TO REGISTER:

$475

$505

Non-Member

1. Online at www.icoi.org

$250

$300

$350

$400

ICOI Member Non-Member

Practitioner:

(must submit full-time status with registration)

Full-Time Student:

(must submit full-time status with registration)

AUXILIARY SESSION:

ADIA Member: $295

Non-Member: $395

Name Please Choose One:

Dental Hygiene

Practice Management

Dental Assisting

Implant Coordinator

ACCOMPANYING PERSONS: ......................................................$

2. Credit Card: Complete information below and fax to (973) 783-1175 3. Mail (make checks payable in US funds to ICOI): 55 Lane Road, Suite 305 Fairfield, New Jersey 07004 phone: (973) 783-6300

THREE WAYS TO REGISTER: MasterCard

Visa

American Express

Credit Card Number:

$150 per person (admittance to scientific session or ADIA programs not included)

PRE-CONGRESS COURSES: Thursday, September 27th There will be a number of Pre-Symposium courses on Thursday, September 27th. Please visit our website www.icoi.org for details.

Billing Zip Code:

CVV No:

Exp. Date: month

year

* All on-site payments must be made by credit card or in cash (USD)

Bellagio Hotel, 3600 Las Vegas Blvd S., Las Vegas, NV 89109 • (888) 987-6667 Discounted rate is $289 until August 21, 2018