ITD Demo Days Enrolment Form – 2025 Summer – ITD Dentistry Practice Centre

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Demo Days 2025 Enrolment Form

Thank you for your interest in attending a FREE Lecture and Demo with Dr. Ankur Rampal

— The event will take place at ITD Dentistry Practice Centre, Dixie Road
— The date and time will be confirmed by email or text via WhatsApp or SMS
— Invitations will be sent when we reach suitable enrolment
— Please complete the Information Form to make an Invitation Request

Invitation Request

Name *

First

Last

Address & Postal Code *

Phone Number *

Email *

Email

Confirm Email

Copyright Notice *

Yes. I understand all ITD Webinar and demo material are copyright ITD Dentistry Practice Centre. I will not record, tape, the sessions or copy the material presented in sessions

Contact Information *

Yes. I have included accurate and current contact information, including address and postal code, which will be used for ITD adminstration and to inform me of upcoming Demos and Registraions

Attendance Confirmation *

Yes, I will attend when registration is confirmed. If I am unable to attend, I will contact ITD well before the start time and inform them of my situation

Your Education *

Your Work Experience *

Days I am Available *

Wednesdays
Fridays
Saturdays
Sundays

Times I am Available *

Noon to 3:00 pm
3:00 to 6:00 pm
7:00 to 10 pm

Notes or Specific Requests