Refunds/Cancellation Participants cancelling more than 90 Days prior to the course will be refunded less a $200 admin fee. Participants cancelling less than 90 Days but more than 30 Days prior to the course are not entitled to a refund but are allowed a one time carry over of course fees to the next available Dr. Braun’s course without penalty. Participants who cancel 30 Days prior to a Dr. Braun’s course and who have already carried over course fees will not be entitled to any refund or further carry over. Costs incurred for travel and hotel accommodations remain the responsibility of each participant. 21 CE Credits First name: Last name: Address: City: Prov: Postal Code: Phone: Email: Payment Information: Are you an AGD Member? YES NO Membership #: Visa MasterCard Amex Cheque (*Please endorse cheques to Palmeri Publishing Inc.) Amount Authorized: $ Card Number: Exp. Date: Card Holder Name: Signature: Fax Completed Form to: (905) 489-1971 Mail Completed Form to: Palmeri Publishing Inc. 35-145 Royal Crest Court, Markham ON L3R 9Z4 Call: 1-866-581-8949 ext 206 / 207 for information REGISTRATION Approved PACE Program Provider FAGD/MAGD Credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement 9/1/2013 to 8/31/2015 Provider ID# 355116 A Three Day Hands-on Seminar March 27 th - 29 th , 2015 Dr. Edy Braun, Hon. BSc, DDS, Cert. Perio, FRCD(C) Periodontics for the GP A Practical Approach $2,299 + HST Periodontics for the GP A Practical Approach March 27 th - 29 th , 2015 $2299 + HST SpringHill Suites by Marriott Toronto Vaughan 612 Applewood Crescent, Vaughan, On L4K 4B4 35-145 Royal Crest Court, Markham ON L3R 9Z4 (905) 489-1970 ext 206/207 | 1-866-581-8949 for information [email protected] / [email protected] Dr. Edy Braun, Hon. B. Sc., D.D.S., Cert. Perio, F.R.C.D.(C) is a periodontist who earned his B.Sc. and D.D.S. from the University of Toronto (2001). After general practice residencies and a periodontal program in the USA, Dr. Braun became board certified by the Royal College of Dentists of Canada in 2007. He currently practices at his periodontics specialty office in Vaughan. SpringHill Suites by Marriott Toronto Vaughan 612 Applewood Crescent, Vaughan, ON L4K 4B4 Please note that by giving us your email, you are giving Palmeri Publishing Inc. permission to send you emails/CEM’s. We respect your privacy and you can unsubscribe from our emails at anytime. Palmeri Publishing Inc. Scan the QR code to join our mailing list. We’ll email you our newsletter, great information and special offers. Thank you to Our Sponsors: Palmeri Media Group A division of Palmeri Publishing Inc. Accommodation Information: SpringHill Suites by Marriott Toronto Vaughan 612 Applewood Crescent, Vaughan, ON L4H 0R2 For Reservations Call: 1-877-515-4070 Cut Off Date: February 25, 2015 Type of Room: 1 King Standard/Double Queen Standard Rate: $129.00 (Plus Taxes) Amenities Include: Hot Buffet Breakfast, Local Phone Calls, WIred and Wireless High Speed Internet Access, Complimentary Parking Reservation Link: http://cwp.marriott.com/yyzsv/palmeripublishing Reservation Block: Palmeri Publishing