Personal Details

Title *

First name *

Last name *

Job title

Department *

Organization *

Address *

Address (line 2)

Country *

Telephone *

Country Code

-

Area Code

-

Number

Fax

Country Code

-

Area Code

-

Number

Email address *

Hong Kong Dental Council Number

HKDA Member Number


  Early Bird
(on or before 15 May 2019)
Standard
(16 May - 22 Jul 2019)
Congress Registration:
Dentist
Dental Office Personnel
Dental Surgery Assistant
Dental Hygienist
Dental Technician
Dental Therapist
Dental Student
(Full-time Post-graduate / Undergraduate) *
Registered Nurse
Trade & Industry Representative
Accompanying Person (Joining with fully paid participants who registered as Dentist only)
  Number of Accompanying Person:
One Day Lecture Only
Social Event
Gala Dinner (HKDA member only)
Gala Dinner (Non-HKDA member)
* Proof of status is required by uploading the .doc / .pdf / .jpg / .png / .tiff file to the system


Workshop Registration

Workshop Early Bird
(on or before 15 May 2019)
Standard
(16 May - 22 Jul 2019)
Workshop 1: The Use of CBCT in the Diagnosis, Treatment Planning and Management of Periodontal Disease
2 August 2019 (Fri)
Workshop 2: A Guide to Understanding the OPG and 3D Imaging
3 August 2019 (Sat)


Hotel Reservation

Hotel Reservation One Night Deposit#
(per room per night)
 
HK$ 1,320.00 / US$ 171.00
HK$ 1,650.00 / US$ 213.00
HK$ 825.00 / US$ 107.00

Payment

Currency *


( * Compulsory field )

Data Protection
All the information provided in this form will be used by the Hong Kong Dental Association (HKDA) and may be transferred to authorized parties involving personnel, agents, advisers, auditors, contractors, sponsors and service providers for the purposes of processing the registration, making reservation of rooms, granting CME/ CPD points for attending the events/ courses and handling relevant matters relating to the HKIDEAS 2019. You are required to supply the data in order to make the registration and reservation. Failure to provide the information may render your registration unsuccessful or delayed. You have the right to request access to and make correction of your personal data held by HKDA. You should make your data access request to HKDA by email at hkideas@hkda.org or by fax at (852) 2529 0755 or by mail to 8/F, Duke of Windsor Social Service Building, 15 Hennessy Road, Wan Chai, Hong Kong.