REGISTRATION FORM Prof. Dr. Mr. Miss MALE FEMALE NAME: ________________________________________________________________________________________ POSITION: ________________________________ SDS NO.: ___________ SCFHS NO.: ______________________ ADDRESS: _____________________________________________________________________________________ P.O. BOX: ______________________ CITY: ________________________ MOBILE NO.: ________________________________ AREA CODE: _______________ EMAIL: _________________________________________ COURSE TOPICS 1. A MASTER CLASS IN CREATIVITY, DESIGN AND EFFICIENCY Speaker: Mr. Imad Ghandour Tuesday, 5 January 2016 - 9:00 am – 5:30 pm Venue: Hall A, Room 2, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 40 2. HOW TO USE AND WORK WITH STEM CELLS? Speaker: Prof. George Huang Tuesday, 5 January 2016 - 1:30 - 5:00 pm Venue: Hall B, Rooms 3&4, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 80 3. IMPLANT A-Z WORKSHOP BLENDING THE ART OF SURGERY AND PROSTHETIC IN IMPLANTS Speakers: Dr. Osama A. Noorwali / Dr. Sahar Alhajrassi Tuesday, 5 January 2016 - 1:30 - 5:30 pm Venue: Hall A, Room 1, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 40-50 4. WAVE ONE GOLD (NEW NiTi SYSTEM) Speaker: Dr. Marco Martignoni Wednesday, 6 January 2016 - 9:00am - 12:00 noon; 1:00 - 5:00 pm Venue: Hall A, Room 1, Riyadh Int’l Convention & Exhibition Center No. of Participants: 25 (AM); 25 (PM) 5. COMPUTER-GUIDED IMPLANT PLACEMENT WITH IMMEDIATE PROVISIONALIZATION Speakers: Dr. Fawaz Al-Qahtani / Dr. Talal M. Al-Nassar Wednesday, 6 January 2016 - 9:00 am - 5:00 pm Venue: Hall B, Room 3, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 25-30 Select Early Registration (Deadline: 17 December 2015) On-Site Registration SR 1,500 SR 1,800 SR 800 SR 1,000 SR 400 SR 600 SR 1,500 SR 1,800 SR 2,500 SR 3,000 6. ADVANCED LOCAL ANESTHESIA COURSE Speakers: Dr. Nasser Al-Asseri Wednesday, 6 January 2016 - 9:00 am - 12:00 noon Venue: Hall B, Room 4, Riyadh Int’l Convention & Exhibition Center No. of Participants: 40 -50 7. CONE BEAM CT BASED DENTISTRY IN DENTAL TRAUMATOLOGY AND ENDODONTICS Speaker: Dr. Mitsuhiro Tsukiboshi Wednesday, 6 January 2016 - 1:30 - 5:30 pm Venue: Hall A, Room 2, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 30 8. HOW TO PREPARE A PRIVATE DENTAL CLINIC Speakers: Dr. Abdulrahman Al-Sarhan, Dr. Mousa Al-Jaload, Dr. Saud Nagshabandi Wednesday, 6 January 2016 - 1:30 - 5:00 pm Venue: Hall B, Room 4, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 40 9. ESTHETIC CROWNS IN PEDIATRIC DENTISTRY Speaker: Dr. Hassan S. Halawany Wednesday, 6 January 2016 - 9:00 am - 5:30 pm Venue: Phantom Lab., KSU-College of Dentistry, BUC No. of Participants: 20 10. APPLICATIONS OF BOTILUNIM TOXIN A (BOTOX) AND HAYLURINIC ACID (FILLER) IN DENTISTRY Speaker: Dr. Hessa M. Al-Wayli Wednesday, 6 January 2016 - 9:00 am - 5:00 pm Venue: Dental Clinic, KSU-College of Dentistry, BUC No. of Participants: 40-50 11. DIGITAL REVOLUTION THE LEARNING CURVE Speakers: Dr. Alessandro Agnini / Dr. Andrea Mastrorosa Wednesday, 6 January 2916 - 9:00 am - 12:00 noon Venue: Hall A, Room 2, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 12. MAXILLARY SINUS GRAFTING TECHNIQUE: STEP BY STEP GUIDE Speakers: Dr. Nabih Nader / Prof. Ibrahim Nasseh / Dr. Ronald Younes Thursday, 7 January 2016 - 9:00 am - 5:30 pm Venue: Hall B, Room 4, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 40 13. HOW TO PLAN DENTAL IMPLANT TREATMENTS Speaker: Dr. Faleh Tamimi Marino Thursday, 7 January 2016 - 9:00 am - 12:00 noon Venue: Hall A, Room 2, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 30-40 14. 3D SMILE DESIGN TECHNOLOGY Speaker: Dr. German Gomez Thursday, 7 January 2016 - 9:00 am - 5:30 pm Venue: Hall B, Room 3, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 40 SR 600 SR 800 SR 600 SR 800 SR 300 SR 500 SR 1,500 SR 1,800 SR 1,500 SR 1,800 SR 2,000 SR 2,400 SR 1,500 SR 1,800 SR 1,000 SR 1,300 SR 3,500 SR 4,000 15. SHAPING, CLEANING AND OBTURATING ROOT CANALS IN THREE DIMENSIONS Speaker: Prof. Gianluca Gambarini Thursday, 7 January 2016 - 9:00 am - 5:00 pm Venue: Hall A, Room 1, Riyadh Int’l. Convention & Exhibition Center No. of Participants: 30 SR 2,000 SR 2,500 Name of Bank: Riyadh Bank Bank Account Name: Saudi Dental Society Bank Account No.: 286 095 45 999 50 IBAN No.: SA 672 000 000 286 095 45 999 50 Please send your receipt of payment and registration form by fax – (011)-4677765 or email to sds.membership@yahoo.com