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APPLICATION FORM

“Competence in Esthetics“

Date: 10 to 11 November 2017
Venue: Austria Centre Vienna, Bruno-Kreisky-Platz 1, 1220 Vienna, Austria www.acv.at


Please complete one form per participant. Only forms where the fields marked with * are completed can be considered!

Company name:*:
Title:
First name*:
Last name*:
Street/No.*:
CIP*: City*:
Country*:
Phone:
Fax:
Mobile:
E-Mail*:

By indicating my e-mail address I agree to receive news from Ivoclar Vivadent AG by email. I have the right to revoke all my consent at any time by sending a message to office.wien@ivoclarvivadent.com.

Invoicing name:  (if other than above)
Invoicing address:  (if other than above)

Registration

Registration after 31 July 2017 EUR 230.00
 
Students*/Assistants EUR   95.00
 
* Students must be enrolled in a dentistry or at an accredited school for dental technicians.
Please enclose a copy of your student ID card when submitting your registration form.
 

Workshop Packages

Entrance fee and Esthetic Party included

10 and 11 Nov, 09.00 - 17.00

Dental Concept - IPS e.max Press Multi & Digital
Digital Optimization & Esthetics: A winning combination
(two-day course)

Dominique Vinci (CH)

incl. entrance fee CiE and Esthetic Party
EUR   620.00
 
11 Nov, 09.00 - 17.00

The 3D-Architecture of Smile Design
Florin Cofar (RO)

incl. entrance fee CiE and Esthetic Party
EUR 1300.00
 

Accompanying person(s) for Esthetic Party
 
number of accompanying person(s): 
EUR     65.00
 
Yes, I need a headphone for the translation

 

Credit Points
Number of education points may vary from country to country.
Austrian participants will receive 14 education points.

All lectures will be held in English.

The entrance fee includes
Dental exhibition
Competence in Esthetics program
Coffee breaks
Dinner party on Friday evening
(show program & live music)
Finger-food lunch-buffet on Saturday


Hotel Reservation

 

I reserve the following hotel and room category:

 
Single
Double
No hotel reservation
Arcotel Kaiserwasser **** EUR119.00 EUR139.00
Hotel Park Inn **** Fully booked
Hotel Ibis Wien Messe *** EUR72.00 EUR89.00
 


Please mark the required room category in the respective line. The offered rates are per room and per night and include breakfast buffet, 13 % VAT and local tax.

  Arrival:  11 2017 Departure: 11 2017
 
I share a room with:

1. Your booking will be reconfirmed upon receipt of your reservation form and payment.
2. Your credit card will be charged with the accommodation costs according to your reservation.
    Any additional nights and extras have to be paid directly at the hotels.
3. In case of no-show or late cancellation the hotels do not grant any refund.
4. Cancellation deadline for the reservation is 28 Sep 2017.
5. Check-in time: from 15 pm, check-out: until 10 am.


Payment, terms of participation

Services can be paid for via bank transfer or by credit card.
The organiser accepts cancellations until 9 October 2017 only. In this case the sum will be refunded after a fee of 25 % for technical costs has been deducted.
In case of cancellations after 9 October, no refunds will be made.

Registered participants prevented from attending the event are entitled to send another person in their place at no additional charge.
Name changes can be made by e-mail until two weeks prior the event.

I pay by bank transfer

Account name: admicos. Congress Incentive GmbH
Bank: UniCredit Bank Austria AG
SWIFT: BKAUATWW
IBAN EUR: AT98 1200 0006 0851 9179

I pay by VISA or Mastercard
compulsory in correlation with hotel reservation

 
Registration
Registration is compulsory (please bring a confirmation of the payment).
To make a hotel reservation please return this form by 25 September 2017 at the latest.
The organiser reserves the right to alter the program!
I accept all the terms of participation and undertake to pay the sum as marked in the application form within 8 days after registration.