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Application Form 3-day comprehensive training course in Inhalation Sedation Dr. Richard Charon BDS (VU Manc.1975) Accredited by IACSD (Intercollegiate Advisory Committee for Sedation in Dentistry - April 2015)

Leading to a Certificate of Competency in Inhalation Sedation March 2017 onwards Day 1 Theory and Practical Demonstrations Days 2 & 3 Work-Based Assessments Venue:

Regency Park Hotel, Bowling Green Rd, Thatcham, Berks RG18 3BY

Date:

Name : ...............................................................................................................................

Qualifications: …………………………………………………………………………………………………………….

GDC Registration Number ....................................................................


Practice Name .................................................................... Practice Address ....................................................................

.................................................................... .................................................................... Post Code .......................................Tel: ........................... email:.......................................

Please enter additional places requested. Please book a place(s) for my dental hygienist(s)/Therapist(s) ................ Please book a place(s) for my registered Dental Nurse(s) ................

Course fees: Should be made by direct (online) bank transfer *BACS please. Including lunch, refreshments, handouts, Workbook, resources, vCPD and Competency certificates and mentor contact for 12 months.

£2520.00 per GDP, Hygienist or Therapist Total = £............... £260.00 per Dental Nurse vCPD learning – Attendance certificate BUT this is not a certificate in Dental Nurse Sedation available via NEBDN only. Total = £...............


50% of the full fee must be made 2 months in advance for this full course to secure places. The balance to be paid in full 2 weeks before the first of the 2 days of Work-based Assessment to be booked at your practice/clinic

BACS PAYMENTS DETAILS A/C No: 21549834:

Sort Code: 56-00-03

International inter-bank transfers: IBAN: GB76NWBK56000321549834 BIC: NWBKGB2L If needed: Account Name: Richard Charon

NB: PLEASE ENTER YOUR OWN NAME AS THE REFERENCE SO WE CAN TRACE WHO HAS MADE THE PAYMENT. THANK YOU.

Fee for Community or hospital-based Dentists or DCPs attending Day 1 only = £533.50 As per The RA Coach website Please e-mail: richard@the-ra-coach.co.uk Mobile: 07884 230995: Web: www.the-ra-coach.co.uk Blog www.theracoach.blogspot.com

Accredited Inhalation Sedation Course Application Form march 2017 to Dec 2018  

Inhalation Sedation Training by Dr. Richard Charon BDS IACSD, RCS STAC Accredited & Dental Council Ireland verified 3-day course

Accredited Inhalation Sedation Course Application Form march 2017 to Dec 2018  

Inhalation Sedation Training by Dr. Richard Charon BDS IACSD, RCS STAC Accredited & Dental Council Ireland verified 3-day course

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