Hands-On Registration

Symposium Registration Number *(Hands-on participants must be registered as symposium participants to get the registration number, please look at the invoice and confirmation email sent by the committee)

Full Name *

Email Address *

Phone *(WhatsApp number is preferred)

Status of IKARGI Membership *IKARGI MemberNon-IKARGI Member

Profession *DMFR ResidentDMFR SpecialistNon-DMFR / Other (Undergraduates, General Practitioners, Specialists)(Choose one following category)

Hands-On Registration *[HO1] Dr. Farina Pramanik - CBCT in Modern Dentistry: Endoscopic Integration, Airway Analysis, Segmentation and 3D Planning - 18 July 2025 (13.00-15.00)[HO2] Dr. Dananjaya Agung - Basic of CBCT 3D Application for Better Daily Dental Treatment - 18 July 2025 (13.00-15.00)[HO3] Dr. Fadhlil Ulum - Attractive Visualization for Precision Endodontics Analysis with CBCT - 19 July 2025 (08.00-10.00)[HO4] Dr. Aloysius Putut - Introduction CBCT: The Role in Maxillary Sinus Lift Procedure - 19 July 2025 (08.00-10.00)[HO5] Dr. Ahmad Badruddin Ghazali - Revolutionizing CBCT Imaging: AI-Driven Innovations and Hands-On Training with Vista Technology - 19 July 2025 (10.00-12.00)[HO6] Dr. M. Novo Perwira Lubis - Surgical Guide Design Using AIS3D App - 19 July 2025 (13.00-15.00)(Each participant may participate in more than one hands-on, please refer to the provided schedule for the date and time of each workshop)

Hands-On Registration *[HO2] Dr. Dananjaya Agung - Basic of CBCT 3D Application for Better Daily Dental Treatment - 18 July 2025 (13.00-15.00)[HO3] Dr. Fadhlil Ulum - Attractive Visualization for Precision Endodontics Analysis with CBCT - 19 July 2025 (08.00-10.00)[HO4] Dr. Aloysius Putut - Introduction CBCT: The Role in Maxillary Sinus Lift Procedure - 19 July 2025 (08.00-10.00)[HO5] Dr. Ahmad Badruddin Ghazali - Revolutionizing CBCT Imaging: AI-Driven Innovations and Hands-On Training with Vista Technology - 19 July 2025 (10.00-12.00)(Each participant may participate in more than one hands-on, please refer to the provided schedule for the date and time of each workshop)

Did you register for the IKARGI MAIN SYMPOSIUM between MAY 1–31, 2025? *YesNo

Coupon Code *State the Coupon Code for IKARGI Members Who Registered on May 1-31st (Please Ask Our Registration Helpdesk via WhatsApp +62816-1510-3097)

Eligibility for Early-Bird Voucher Discount *DMFR SpecialistsDMFR ResidentsGeneral DentistsThis field is valid only for IKARGI members who registered between May 1–31, 2025. Any unverified or mismatched data will result in deferral or rejection from the hands-on session. Please contact our helpdesk for more details.

Total Invoice Amount

Rp.

(Total Invoice to Be Paid)

Payment

Transfer Bank
BRI (Bank Rakyat Indonesia)
No. Account 0580-01-000495-56-4
a/n Simposium Nasional IKARGI XII Surabaya

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