UIC Orthodontics Bioprogressive Technique Program Payment

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Registration Deadline June 30th, 2024

Registration Fee
$2,000.00 U.S. dollars per Participant

Individual Registration Participants must register not less than 30 days prior to the start of the program.

Payments must be made to the College of Dentistry and proof of travel insurance, medical insurance and COVID-19 vaccine must be provided not less than 15 days prior to the start of the program. For regular registration Participants, CLIENT shall pay the College of Dentistry the sum of $2,000.00 US dollars per participant.

For questions or concerns, please email Huibi Liu at: ortho@uic.edu

Are you registering individually or as a group?*

Individual

Group

Number of Participants:

Number of Participants

Participant First Name:

Participant Last Name:

Please provide proof of travel insurance. (Upload must be in PDF format)

Please provide proof of medical insurance. (Upload must be in PDF format)

COVID Vaccine

Yes

Participant Documents: (Uploads must be in PDF format)

Participant Documents: (Uploads must be in PDF format)
Participant Name:	COVID Vaccine	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document

Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document
Participant Name:	Yes No	Proof of Medical Insurance	Proof of Travel Insurance:	Other Document

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