Centrum Clear Aligner – Zapisz się na szkolenie “MASTER IMPLANTOLOGII”

CENTRUM CLEAR ALIGNER - SUBSCRIBE FOR TRAINING

To register for a course, please follow the instructions below:

  1. Complete an online application using the form below
  2. Transfer the requested amount to the account listed below

A&T Dental Solutions s.c
Ayham Mohsin Agnieszka Banaś-Mohsin
ul. Rejtana 9
35-326 Rzeszów
33 1750 1224 0000 0000 1244 0178

PLEASE NOTE! Payment is the precondition for accepting your application. Otherwise, the application will not be considered.

ENTRY FORM

Fill out the application form

COURSE: "MASTER IMPLANTOLOGY AT ATHENEA DENTAL INSTITUTE – 1 EDYCJA"


Name and surname of the course participant (required)

Academic title of the course participant (required)


Correspondence address

Street and house number (required)

Postal code and location (required)

Country (required)

Phone number (required)


E-mail address (required)

Please issue a VAT invoice for the course to the following:

Name(required)

NIP [VAT no.] (required)

Street and house number (required)

Postal code and location (required)

Remarks

Consents:

 I hereby declare that in connection with my willingness to participate in the course/training indicated above, and the completion of the entry form, I was duly informed that professional photographic documentation may be executed during its course, which may include the images of course/training participants.
 I hereby grant my consent to the dissemination of my image, which may be recorded during the course/training – for marketing purposes of the course/training Organiser, related to its business. This consent is granted by me free of charge. The dissemination referred to above – if the Organiser executes a photographic relation from a given training/course – will consist in publishing photos from the training/course on the Organiser's website.
 I express, in accordance with art. 7 sec. 2 (a) of the Regulation of the European Parliament and of the Council 2016/679 of 27 April 2016, i.e. the so-called GDPR, my explicit and voluntary consent to the processing of my personal data (name and surname, e-mail address) by the Organiser of the training/course, i.e. Ms. Agnieszka Banaś – Mohsin and Mr. Ayham Mohsin conducting business activities in the form of a civil partnership A&T Dental Solutions s.c. with a registered office in Rzeszów at ul. Rejtana 9, 35-326 Rzeszów – for purposes related to the activity, promotion, trade and marketing, which will be conducted by the organiser of the training/course. Expressing this consent will result in adding your e-mail address to the mailing list.
 I was duly notified that the Administrator of personal data are Ms. Agnieszka Banaś – Mohsin and Mr. Ayham Mohsin, conducting business activities in the form of a civil partnership A&T Dental Solutions s.c. with a registered office in Rzeszów at ul. Rejtana 9, 35-326 Rzeszów. The Administrator's contact details are as follows: kontakt@clearaligner.pl. I provide my personal data voluntarily on the understanding that it is necessary for accomplishing the purpose. I have the right to request access to my personal data, rectification, deletion or limitation of processing, as well as the right to withdraw consent to processing, oppose processing, as well as the right to transfer my data, the right to be forgotten and bring a complaint to the supervisory authority. After withdrawal of the consent the provided personal data will no longer be processed.