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You are Dentist Stomato Assistant University/Student Other *   if other :    Civility Mister   Madam   Miss   Last Name * First Name * Address *   Zip Code * City * Country * Mail * Phone * Fax I want to attend the « Rendez-vous Internationaux du Laser Dentaire » Thursday, March 13, 2008. I enclose my registration a check payable to « Dental Laser Academy » width the amount of :   300 € for practitioners   250 € for members of Cenalos, WFLD, DLA (attach certificate of membership)   150 € for academics and students (enclose proof) NB : Certificate of attendance provided subject to assumption by the FIPL. Duplicate the code      *  Required field © 2008 - Dental Laser Academy, 27 avenue Kléber, 75116 Paris. Contact