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									   ASSOCIATION OF DENTAL ANAESTHETISTS
       WINTER MEETING, FRIDAY NOVEMBER 12th 2010
                       @
               The King’s Fund
           11-13 Cavendish Square
                London W1G 0AN
          ACCREDITED WITH 5 CPD POINTS




   Advance Notification


Association of Dental
Anaesthetists (ADA)

         Winter Meeting


        12th November 2010



          The King’s Fund
      11-13 Cavendish Square
              London
             W1G 0AN
                                         ASSOCIATION OF DENTAL ANAESTHETISTS
                                                       WINTER MEETING, FRIDAY NOVEMBER 12th 2010
                                                                                          @
                                                                    The King’s Fund
                                                                11-13 Cavendish Square
                                                                     London W1G 0AN
                                                               ACCREDITED WITH 5 CPD POINTS

                                                                  REGISTRATION FORM
Please write clearly in block capitals

Member of the ADA?                          Yes                      No
Title* ........................................................................ Surname* .............................................................................................
First Name* ............................................................. Daytime Telephone ..............................................................................
Address ..................................................................................................................................................................................
........................................................................................................................... Postcode ....................................................
Email address .........................................................................................................................................................................
Title of post held* ...................................................................................................................................................................
Name of Hospital or Trust ......................................................................................................................................................
Dietary requirements ...............................................................................................................................................................
Any further requirements .........................................................................................................................................................
*These details will be used on your conference badge, the attendance list and all conference literature

Accreditation
Please indicate whether you will require a CPD (Dentists) or CPE (Doctors) accreditation certificate:
                                      CPD                          CPE

REGISTRATION FEES AND PAYMENT
Please pay by Sterling cheque drawn on a UK bank and made payable to:
”Association of Dental Anaesthetists”

                ADA Member ……………….Please find enclosed a cheque for the sum of £125.00

                ADA Non-Member …………Please find enclosed a cheque for the sum of £140.00*
                *(This includes eighteen (18) months membership)

Payment can also be made by Credit Card (Visa, Mastercard, Delta, Maestro/Switch (please note we are unable to
accept American Express or Diners Card)

Card/Switch Number .............................................................................................................................................................
Start Date: .................................................................... Expiry Date: ...................................................................................
Security Code: (Last three digits on signature strip) ................................................ Issue No. (Switch Only) ......................
Name on the Card: ........................................................................................................................................................
Statement Address (if different from above) .................................................................................................................
.............................................................................................. Postcode .....................................................................
Cardholder’s signature .......................................................... Date: ............................................................................
 .........................................................................................................................................................
                               Please note we cannot accept telephone bookings.
                               Please return your completed registration form to:
         Winter Meeting 2010, Association of Dental Anaesthetists, 21 Portland Place, London W1B 1PY
              For further information, please visit the ADA website at www.dentalanaesthesia.org.uk
                                         or telephone +44 (0)20 7631 8898
Cancellation Charges
           st
Up to 1 October 2010 a full refund will be given less a £25 administration charge.
         th                    th
From 15 of October 2010 to 29 October 2010 a 50% refund will be given.
        th
After 29 October 2010, no refund will be given.
                    ASSOCIATION OF DENTAL ANAESTHETISTS
                           WINTER MEETING, FRIDAY NOVEMBER 12th 2010
                                            @
                                    The King’s Fund
                                11-13 Cavendish Square
                                     London W1G 0AN
                               ACCREDITED WITH 5 CPD POINTS


                            Symposium General Information


Website      http://www.dentalanaesthesia.org.uk/

Venue:       The King’s Fund
             11-13 Cavendish Square
             London W1G 0AN
             Email: info@dentalanaesthesia.org.uk

Directions/car parking:

http://www.kingsfund.org.uk/how_to_find_us.html

Accommodation:

As this is a one day meeting, no arrangements have been made for accommodation.
However, there are quite a few hotels within a short walking distance of the conference
venue.

Please see the link below for the recommended hotel from The King’s Fund which offers
preferred rates:

http://www.chesterfieldmayfair.com/kingsfund

Please see the link below for another closely located hotel to The King’s Fund:

http://www.saintgeorgeshotel.com/


Please book your accommodation as soon as possible if required as there will be a
number of events taking place in the area on the day.

								
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