Where:
University of New Mexico – North Campus
Division of Dental Hygiene 2320 Tucker NE
Albuquerque, NM 87131
(505) 272-4513
FAX (505) 272-5584
Date: October 3-5, 2007
Cost:
$350 per attendee
$400 after September 15, 2007
Name:__________________________________________________________________
Address:________________________________________________________________
City:___________________________________________________________________
State:__________________________________________Zip:______________________
Phone:__________________________________________________________________
Email:__________________________________________________________________
Payment By:
Checkٱ Mastercardٱ Visaٱ
Total Payment Amount:__________________________
Credit Card#_____________________________________________________________
Expiration Date:__________________________________________________________
Please make checks payable to:
UNM Dental Hygiene
1 University of New Mexico
MSC09 5020
Albuquerque, NM 87131
You may fax your registration with credit card information to (505) 272-5584
For more information please contact cnathe@salud.unm.edu.
Visit our website at http://hsc.unm.edu/som/dentalhy