Curriculum 2022 / 2023

Personal

Desired city* Gommiswald/Switzerland (German)
Moscow/Russia (Russian)
Sofia/Bulgaria (Bulgarian)
Cluj & Bukarest/Romania (Romanian)
Belgrade/Serbia (Serbian)
Budapest/Hungary (Hungarian)
Dehli/India (English)
Kiev/Ukrain (English)
Spain (Spanish)

First and Family Name*

Gender*

Date of birth*

Place of birth*

Country

Phone number*

Email*

Address office

Str.*

ZIP*

City*

Country*

Phone number

Email

Name of institution / hospital / practice

Address residence

Str.

ZIP

City

Country

Phone number

Qualification

Graduation

Year*

College / University*

Post graduation

Year

College / University

Practise licence no

State

Country

Specialisation

General dentist

Specialisation

Number of operatories

Implant courses taken / Specialisations

Practical experience

For how long

As implant surgeon

As restorative dentist

How many implants placed / restored / both (totally)

Present frequency per month

Implant systems in use

Experience in Immediate Loading Regular Yes, some No

Preferred mode to contact* Phone Mobile phone Email

Please upload a passport picture
(3.5 x 4.5 cm, 300 dpi, as .jpg)*

Security

Thank you for the registration.

We will contact you as soon as possible.

>

×