Melbourne Dental School

REGISTRATION FORM: 2008 CONTINUING PROFESSIONAL DEVELOPMENT PROGRAM

This form cannot be submitted on line. It can be used as a template to print and forward by fax or post to the Dental School.

Before enrolling, please read registration conditions.

Please forward this REGISTRATION FORM and return it by mail together with your DEPOSIT CHEQUE to:

Ms Samantha Vassallo La Rosa ,
Continuing Professional Development,
Melbourne Dental School,
The University of Melbourne,
720 Swanston St, Melbourne VIC 3010.

Email: sam.v@unimelb.edu.au

PH: (03) 9341 1506
FAX: (03) 9341 1595

Please contact the CPD Office if confirmation of your enrolment is not received 14 working days after submission.

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