Registration Form for Veterinary Dental Consulting Seminars—Fall 2014 Please mark seminar/s attending. Completed form can be attached and emailed to: pat@veterinarydentalconsulting.com. o Canine Dentistry Seminar, Saturday, October 4, 2014 Fee: $385 Saturday only, $660 both days o Feline Dentistry Seminar, Sunday, October 5, 2014 Fee: $385 Sunday only, $660 both days o Basic Veterinary Dentistry Seminar, Saturday, November 1, 2014 Fee: $250 Saturday only, $400 for full weekend o Anesthesia Monitoring for Dental Patients, Sunday morning, November 2, 2014 Fee: $150 Morning session only, $250 full day Sunday or $400 full weekend o Dental Radiography, Sunday afternoon, November 2, 2014 Fee: $100 Afternoon session only, $250 full day or $400 full weekend Name/s: _______________________________________________________________________ DVM_____________ Technician_____ ____ Assistant____ _______ Total registration fee : ________________ Practice: Address: Phone number: Email: Payment can be made by check made out to Veterinary Dental Consulting and sent to 2210 W. Main St, Ste 107, #218, Battle Ground, WA 98604. Thank you. Pat Frost Fitch, DVM, DipAVDC Veterinary Dental Consulting Battle Ground, WA 360-263-7636 pat@veterinarydentalconsulting.com