Congress Registration Fee
  Before 2010/4/30
(1st April)		 After 2010/4/30
(1st April)		 On the 1st Day of the Congress
(Limited)
1 Dentist 100$ 150$ 200$
2 Technician 50$ 80$ 100$
3 Hygienist 50$ 80$ 100$

* The registration fee includes: Lunch and visiting Milad Tower.

* Required Fields
Last name * :  
First name * :  

N.C. (National Code) * :  
Medical License Number :  
IDA Membership Number :  
Mailing Address :  
City :  
Country :  
Zip / PostCode :  
(Please include FULL international dialing code).
Telephone (Office) :  
Telephone (Home) :  
Mobile:  
Email :  

Participant in :
 
  
IDA Secretariat Mailing Address:
No. 90 & 94, West Piroozi St., Nasr Place (Ex. Gisha)
P.O Box: 14185-518 Tehran, Iran
Fax: +98 21 88288996
Tel: +98 21 88289256-9
Website: http://www.idaweb.ir
Email: info@idaweb.ir