Please note: by completing this form you are agreeing to the given information being processed, enabling the organisers to send further information to you pertinent to BDTA Dental Showcase. You must also be authorised to complete thsi form on behalf of other members of the team.

To ensure that we can send your ticket in good time before the Exhibition, please fill in your personal and company details as fully as possible (fields highlighted in red are required for registration):

First, the Company/Practice address details: (all tickets will be sent to the first person registered at the address you enter):

Practice/Company:
(if applicable)
  
Address Line 1:
Address Line 2:
Address Line 3:
Town/City:
e.g. London
  
County/State:
Postcode/Zipcode:
Country:
Tel (inc area code):
 
Email:
 

 

Individual details: (These will appear on your badge exactly as you enter them):
(To issue a valid CPD Certificate we will need your GDC Registration number.
Forgotten your GDC Registration Number? Click here to search the GDC Register)

 Title Forename Family Name Occupation
GDC Reg No
1
or
2
or
3
or
4
or
5
or
6
or
7
or
8
or
9
or
10
or
11
or
12
or

DATA PROTECTION: By completing this application form you are agreeing to the given information being processed, enabling the organisers of BDTA Dental Showcase to send further information pertinent to the exhibition. The information will be addressed to the first named person on the form so the information should be completed by this individual. You must also be authorised to complete this registration form on behalf of the other members of the team.