Hygiene Study Club Season Tw Registration
Thank you for your interest in continuing our Virtual Hygiene Study Club series!  Please complete this registration form to it's entirety. Upon registration, you will receive an Evite to your email with a zoom link to access the event!  Should you have any questions, please contact our marketing team at Marketing@smilewithbraces.com.o
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Please provide your full name (as you'd like it to appear on your CE certificate): *
Preferred email address: *
Phone number: *
Name and location of current practice: *
Current position held: *
How long have you held this position? *
We are thrilled you have chosen to join Season Two of our Virtual Hygiene Study Club Series. Please take a moment to tell us how you heard about our study club: *
If invited by a friend/colleague, please provide their name so we may thank them:
Our virtual classroom spots are limited and we'd like to reserve your spot well in advance.  Please tell us which dates you are registering for? *
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