Administration Contact Information

  1. Phone: (402) 707-9641 
  2. Email: b.cole@imagdent.com
  3. Registration Deadline May 9th, 2023
Sign in to Google to save your progress. Learn more
Email *
Cancellation Policy
Space is limited. If you must cancel, and we are able to fill your seat, your tuition will be credited to another course.
Cancellations made after May 15, without transfer to a later course, will be refunded 50%. All cancellations or course transfers will also incur a $100 processing fee. IMagDent is not responsible for fees incurred related to travel expenses, including, but not limited to, airline, rental car, and/or hotel reservations. 
Course Information:
After registration for this course you will receive a link to make payment for this course. 
The link for Hotel registration is: 
Breakfast is included in hotel, lunch will be served during course, dinner locations are available near hotel
Name First and Last *
Billing Address
Office Name *
Contact Phone number *
Dietary restrictions *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy