CDE Registration

REGISTRATION

To register by MAIL:
Send completed registration form along with check payable to UB Foundation or include credit card information and signature in space provided.
University at Buffalo
Continuing Dental Education
327 Squire Hall
Buffalo, NY 14214-8006

To register by FAX:
Fax completed registration form, include credit card information and signature in space provided.
FAX 716.829.2484

To register by PHONE or for additional information call Continuing Dental Education:
Phone 716. 829.-2320
Toll Free 800.756.0328

CONFIRMATION
Written confirmation with course location is mailed upon receipt of your tuition payment.

To register ONLINE:
Fill out the form below.

Continuing Education On-line Registration Form

The registration form below should be used by those would like to:

Mail payment to CDE

Call CDE with credit card information

Your registration will be complete upon receipt of payment by check, money order, or credit card information.

PLEASE NOTE:
To register and submit credit card information on-line use our secure form.

Course Number

Course Title

Registrant

Dentist/Practice Name

Address

Home Address
(for our mailing list)

E-mail

Check One: DDS RDH DA Other

Telephone numbers (please include area code)

Office

FAX

Home

Method of Payment:

Will call with credit card information
Will send check or money order (payable to UB Foundation, Inc.)

If paying by check or money order, send payment to:
University at Buffalo
Continuing Dental Education
327 Squire Hall, 3435 Main Street
Buffalo NY 14214-8006

If paying by credit card please call Continuing Dental Education:
716.829-2320
800.756-0328