HANDS ON REGISTRATION FORM

Your Email*

Your Name*

Your Title*

Affiliation*

Your Phone Number*

Address*

Hands On (you may choose more than one hands on)*
 HO 1 "Effective Way to Manage Gingival Inflammation Post Surgery" by drg. Sri Pramestri Lastianny, MS, SpPerio (K), Friday, 13th August 2021, 14.30-17.30 WIB – Rp750.000,00 HO 2 "Fundamental of Suturing for Daily Practice" by Dr. drg.Dahlia Herawati, SU, SpPerio(K), Saturday, 14th August 2021, 14.30-17.30 WIB – Rp750.000,00 HO 3 "Management of Socket Bleeding Post Extraction" by drg. Cahya Yustisia Hasan, SpBM (K), Friday 20th August 2021, 14.30-17.30 WIB – Rp700.000,00 HO 4 "Aesthetic Splinting: Tips and Tricks" by drg. Christianie, Sp.Perio, Sunday, 15th August 2021 - Rp1.900.000,00 HO 5 "Clinical Laboratory Test in Daily Dental Practice" by dr. Nuur Naafi Ulloh, MSc, Sp.PK., Friday 27th August 2021, Friday 27th August 2021, 14.30-17.30 WIB – Rp500.000,00

NPA* (if you are local dentist/ IPERI member please input the NPA number of PDGI. For international participants, please input “0000”)

Date of Transfer*

Upload Bank Transfer Receipt*

Please transfer the total amount of fee for hands on which has been selected to:
Bank Mandiri
No. Rek: 137 001 648 7726 (Hendrawati)

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