Bicon Course Online Registration
  • The tuition fee is per person, non-negotiable and non-transferable.
  • Registration is not complete until payment is made in full.
  • Early registration is encouraged.
  • Bicon reserves the right to limit registration.
Course Name
Harvard Implant Course
How did you hear about Bicon?
What is your specialty?
Name
*
Address
*
City, State, ZIP
Province (if applicable)
Country
Phone
(only numbers please, no space nor symbols)
*
Fax
Email
*
Type comments or questions
Payment Information
Registration Fee
Basic : HKD 23,800 (Early: HKD 18,800)
Advanced : HKD 20,800 (Early: HKD 15,800)
Package (Basic & Advanced) : HKD 40,800 (Early: HKD 30,800)
Card Type
VISA MASTER
Name of Cardholder
Card Number
Expiration (MM/YY)
Card Security Code
Note: If you prefer, you may call or fax with your payment information.
Registration is not complete until payment has been received.
Will you require a hotel
reservation at JJ Hotel?
YES NO
Date of arrival
Date of departure

I authorize Bicon to photograph me during the course(s). I understand that these images
may be used for educational purposes, publications, brochures, and/or the Bicon website.
I understand the photos will not be used in a manner that may be deemed inappropriate.

I understand that if I practice in a country where Bicon has a distributor, then I shall purchase
all Bicon products from that representative and not from the Bicon office in Boston.

I hereby agree to the terms and understand the conditions listed above.

Bicon (HK) Ltd.
#1501 Leighton Centre, 77 Leighton Road, Causeway Bay, Hong Kong
Tel: (852) 3154 9407
Fax: (852) 3007 5196
e-mail: info@bicon.com.hk



Copyright © 2006 Bicon(HK) Ltd.
All rights reserved.