___I want to enroll in all 5 Segments (Orthodontists)- each segment $900
Tuition: $4,500.
___I want to enroll in all 5 Segments (Part-time faculty, specialty residents)- each segment $600 Tuition: $3,000.
___I want to enroll in all 5 Segments (Full-time faculty, residents)- each segment $300
Tuition: $1,500.
___ Occlusofacial Simulator™ starter kit $2,500.00
*(required)
Tuition is due upon registration. To enroll, please fill out and return the registration form page (or a copy), mark your calendar, and make hotel and travel arrangements.
Payment: Please send payment (by check in U.S. Funds payable on a U.S. Bank only, or use your Visa or MasterCard) to:
The Andrews Foundation Tel. (800) 799-8952 (in USA only), (619) 224-0866
2025 Chatsworth Blvd. Fax. (619) 224-6979 E-Mail:drandrews@msn.com
San Diego, CA 92107 Website: www.andrewsfoundation.org
_____Visa _____Mastercard. Acct. #________________________
Exp. date ______
Amount Enclosed $_____________________ Telephone no. (____)______________
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Name (Please Print) Dental School Yr. of Grad.
____________________________________________________________________
Signature Orthodontic School Yr. of Grad.
____________________________________________________________________
Address
____________________________________________________________________
City State Zip (Postal) Code
____________________________________
Country
____________________________________________________________________
Fax. no. E-mail address
___ I would like to include the price of the textbook “Straight Wire, The Concept and Appliance”. The price of the book is $125.00(US) plus shipping and handling ($10 U.S., $20 Outside Continental U.S.). California Residents please add $7.75% sales tax ($9.69)
Cancellation Policy: The Andrews Foundation reserves the right to cancel or postpone any course due to unforeseen circumstances or insufficient enrollment. In the event of such cancellation, full tuition will be refunded. For enrollees, there will be a full refund (less a $100 administration fee) for cancellations six weeks prior to the 1st Segment; there will be no refund or credit given if cancellation is less than six weeks prior to the course unless enrollee can locate a qualified replacement or the vacated spot can be filled from a course waiting list. The Andrews Foundation assumes no responsibility for transportation or lodging.