IFloss
 
Illinois Oral Health Conference
September 7 & 8, 2017
Marriott Bloomington-Normal Hotel & Conference Center
Bloomington/Normal, IL




Conference Registration

Please fill out the following information to register for this conference. By providing your phone and email address you let us contact you if needed.

After you fill out the form and click Submit, you will be taken to a confirmation page that you may print out and send with a check, or pay immediately with the Paypal "Pay Now" button.

If you prefer, you may register by mail by clicking here and printing out and mailing pages 5-6 of the form.


You may join IFLOSS by clicking here or online here to obtain member rates for the conference.




Name:


Organization:

Street Address:
  City, State, Zip:



Phone:

Email Address:

Payment Options:

IFLOSS Member Rates
  2 Day -- Early Bird (through 8/1) $200; 8/2/2017 or after $225
  1 Day -- Early Bird (through 8/1) $125; 8/2/2017 or after $150
 
Non-Member Rates
2 Day -- Early Bird (through 8/1) $250; 8/2/2017 or after $275
1 Day -- Early Bird (through 8/1) $175; 8/2/2017 or after $200
 
Student Rate-must be a fulltime Dental/Dental Hygiene/Nursing Student
2 Day -- $145
1 Day -- $85
 
No sessions (pre-session only)
 
For 1-day registrations, select the day:
Thursday, Sept 7th
Friday, Sept 8th
 
Clinical Session Only -- Friday Sept 8. The price reflects only pre-session; add to above registration if attending Wednesday and/or Thursday
Dentist -- $80
Hygienists or Staff -- $60
No Pre-Session
 
Notes:Remember that the price goes up on August 2nd; Registrations close on September 5th.
 
Dietary Restrictions
or Additional
Information:
 




 

     Registration and Information Form
Hotel Reservations at the Marriott in Bloomington-Normal
Guests may call (309)862-9000; Group rate is under IFLOSS Coalition Meeting

Cancel registration and return to IFLOSS website