Registration Form

Program Schedule

• The program is limited to 15 participants per module to enable better personal care and interaction.
• Module I is covered over four days of a weekend (Wednesday, Thursday, Friday and Saturday)
• Module II is covered over three days of a weekend (Thursday, Friday and Saturday)
• Module III is covered over two days of weekend (Friday and Saturday)
• Each module has exhaustive lectures, live patient demonstrations and assessment of the participants hands-on work under the dental operating microscopes

Fees: Depending on their needs participants can also choose to join ANY ONE of the modules at the following rates.

MODULE-I ESSENTIAL ENDODONTICS by Dr Gopi Krishna : Rs. 38,000/-
(Each participant receives an endodontics starter kit comprising of consumables and materials worth Rs. 10,000/- and a complimentary copy of Grossmans Endodontic Practice - 13th edition)

MODULE-II ADVANCED ENDODONTICS by Dr Gopi Krishna : Rs. 38,000/-
(Each Participant receives an endodontic advanced kit comprising of consumables and materials worth Rs. 10,000/-)

MODULE-III SCOPE TRAINING COURSE by Dr Gopi Krishna : Rs. 38,000/-
(Each participant receives an endodontics starter kit comprising of consumables and materials worth Rs. 10,000/-)

DISCOUNTS FOR JOINING MORE THAN ONE MODULE:

OPTION I
Total of Rs 100,000/- (For participants joining all the three Modules by Dr Gopi Krishna after a discount of Rs 14,000 rupees).

OPTION II:
Total of Rs 70,000/- (For participants joining Module I and Module II by Dr Gopi Krishna after a discount of Rs 6,000 rupees).

DIRECT & INDIRECT ESTHETIC MASTERCLASS MODULE (Three-day course by Dr Deepak Mehta, Dr Abby Abraham and Dr Lakshmi) : Rs 30,000

INSTRUMENT RETRIEVAL MASTERCLASS MODULE (Two-day microscope course on BTR Pen by Dr Zaher Altaki) : Rs 52,000

MODE OF PAYMENT

Participants interested in any one of the module can register online after making an advance payment of Rs. 5000/-.

Participants interested in registering for BOTH the modules to avail the discount offer can register online after making an advance payment of Rs 10,000/-.

Participants interested in registering for ALL THREE modules to avail the discount offer can register online after making an advance payment of Rs 15,000/-.

The balance can be paid during the module dates. This advance payment can be made by either BANK TRANSFER / DEMAND DRAFT / CASH

1. BANK TRANSFER

Instructions - In order to book your seat for any ONE of the modules you can make a payment of Rs. 5000/- by bank transfer. You can also book yourself for BOTH the modules by making a payment of Rs 10,000/- by bank transfer.

Bank Name : HDFC Bank
Account Name : Root Canal Centre
Act. No. : 00172000033366
Branch : Anna Nagar Rountana Branch
Branch Address : AA - 8 , 2nd Avenue , Chennai - 600040 , Tamilnadu.
RTGS / NEFT IFSC : HDFC0000017

2. DEMAND DRAFT

Instrucations - In order to book your seat for any of the modules you can make a payment of Rs. 5000/- or if you want to book both the modules then you can make a payment of Rs 10,000/- by making a DEMAND DRAFT in the name of " ROOT CANAL CENTRE " and payable at Chennai. You can courier the draft to the following address.

Root Canal Foundation
Sri Arcade, D Block, New No 91,
Anna Nagar First Avenue,
Chintamani Signal, Anna Nagar East,
Landmark: Next to Raymond showroom,
Chennai – 6000102.
Phone: +91 - 44 – 42171813

3. CASH

Instrucations - In order to book your seat for any of the modules you can make a payment of Rs. 5000/- or if you want to book both the modules then you can make a payment of Rs 10,000/- by CASH at the above mentioned address.

Module I - Annual Young Achievers Scholarship Module by Dr.GopiKrishna Feb 14, 15, 16 - 2014 FRI, SAT, SUN Close Registration Closed Feb 25, 26, 27 - 2015 WED, THU, FRI Close Registration Closed Feb 25, 26, 27 - 2016 THU, FRI, SAT Close Registration Closed Feb 25, 26, 27 - 2017 SAT, SUN, MON Close Registration Closed Feb 25, 26, 27 - 2018 SUN, MON, TUE Close Registration Closed Feb 25, 26, 27 - 2019 MON, TUE, WED Close Registration Closed Feb 25, 26, 27 - 2020 TUE, WED, THU Close Registration Closed Sep 11, 12 - 2022 SUN, MON Close Registration Closed
Module II - Advanced Endodontics by Dr.Lakshmi & Dr.GopiKrishna Dec 19, 20 - 2014 FRI, SAT Close Registration Closed Jun 18, 19, 20 - 2015 THU, FRI, SAT Close Registration Closed Nov 19, 20, 21 - 2015 THU, FRI, SAT Close Registration Closed Apr 07, Dec 09, 09 - 2016 THU, SUN, SAT Close Registration Closed Oct 05, 06, 07 - 2016 WED, THU, FRI Close Registration Closed Apr 27, 28, 29 - 2017 THU, FRI, SAT Close Registration Closed Nov 16, 17, 18 - 2017 THU, FRI, SAT Close Registration Closed Apr 19, 20, 21 - 2018 THU, FRI, SAT Close Registration Closed Nov 22, 23, 24 - 2018 THU, FRI, SAT Close Registration Closed Apr 19, 20, 21 - 2019 FRI, SAT, SUN Close Registration Closed Jun 20, 21 - 2019 THU, FRI Close Registration Closed Sep 19, 20, 21 - 2019 THU, FRI, SAT Close Registration Closed Oct 10, 11, 12 - 2019 THU, FRI, SAT Close Registration Closed Apr 16, 17, 18 - 2020 THU, FRI, SAT Close Registration Closed Oct 22, 23, 24 - 2020 THU, FRI, SAT Close Registration Closed Jan 20, 21, 22 - 2021 WED, THU, FRI Close Registration Closed Apr 21, 22, 23 - 2021 WED, THU, FRI Close Registration Closed May 04, 05, 06 - 2022 WED, THU, FRI Close Registration Closed Aug 28, Dec 09, 30 - 2022 SUN, FRI, TUE Close Registration Closed Apr 14, 15, 16 - 2023 FRI, SAT, SUN Open   Select Jul 06, 07, 08 - 2023 THU, FRI, SAT Open   Select Nov 09, 10, 11 - 2023 THU, FRI, SAT Open   Select
Module I - Essential Endodontics by Dr.GopiKrishna Jan 21, 22, 23, 24 - 2015 WED, THU, FRI & SAT Close Registration Closed Mar 18, 19, 20, 21 - 2015 WED, THU, FRI & SAT Close Registration Closed May 20, 21, 22, 23 - 2015 WED, THU, FRI & SAT Close Registration Closed Jun 24, 25, 26, 27 - 2015 WED, THU, FRI & SAT Close Registration Closed Jul 22, 23, 24, 25 - 2015 WED, THU, FRI & SAT Close Registration Closed Aug 19, 20, 21, 22 - 2015 WED, THU, FRI & SAT Close Registration Closed Oct 07, 08, 09, 10 - 2015 WED, THU, FRI & SAT Close Registration Closed Jan 08, 09, 10, 11 - 2016 FRI, SAT, SUN & MON Close Registration Closed Mar 09, 10, 11, 12 - 2016 WED, THU, FRI & SAT Close Registration Closed May 18, 19, 20, 21 - 2016 WED, THU, FRI & SAT Close Registration Closed Jul 06, 07, 08, 09 - 2016 WED, THU, FRI & SAT Close Registration Closed Sep 07, 08, 09, 10 - 2016 WED, THU, FRI & SUN Close Registration Closed Nov 24, 25, 26, 27 - 2016 THU, FRI, SAT & SAT Close Registration Closed Jan 18, 19, 20, 21 - 2017 WED, THU, FRI & SAT Close Registration Closed Mar 15, 16, 17, 18 - 2017 WED, THU, FRI & SAT Close Registration Closed May 17, 18, 19, 20 - 2017 WED, THU, FRI & SAT Close Registration Closed Aug 16, 17, 18, 19 - 2017 WED, THU, FRI & SAT Close Registration Closed Oct 11, 12, 13, 14 - 2017 WED, THU, FRI & SAT Close Registration Closed Dec 20, 21, 22, 23 - 2017 WED, THU, FRI & SAT Close Registration Closed Mar 07, 08, 09, 10 - 2018 WED, THU, FRI & SAT Close Registration Closed Aug 22, 23, 24, 25 - 2018 WED, THU, FRI & SAT Close Registration Closed Oct 24, 25, 26, 27 - 2018 WED, THU, FRI & SAT Close Registration Closed Dec 19, 20, 21, 22 - 2018 WED, THU, FRI & SAT Close Registration Closed Feb 20, 21, 22, 23 - 2019 WED, THU, FRI & SAT Close Registration Closed May 22, 23, 24, 25 - 2019 WED, THU, FRI & SAT Close Registration Closed Aug 07, 08, 09, 10 - 2019 WED, THU, FRI & SAT Close Registration Closed Oct 16, 17, 18, 19 - 2019 WED, THU, FRI & SAT Close Registration Closed Dec 25, 26, 27, 28 - 2019 WED, THU, FRI & SAT Close Registration Closed Mar 04, 05, 06, 07 - 2020 WED, THU, FRI & SAT Close Registration Closed Oct 28, 29, 30, 31 - 2020 WED, THU, FRI & SAT Close Registration Closed Dec 16, 17, 18, 19 - 2020 WED, THU, FRI & SAT Close Registration Closed Feb 17, 18, 19, 20 - 2021 WED, THU, FRI & SAT Close Registration Closed May 12, 13, 14, 15 - 2021 WED, THU, FRI & SAT Close Registration Closed Jul 22, 23, 24, 25 - 2021 THU, FRI, SAT & SUN Close Registration Closed Sep 28, 29, 30, 01 - 2021 TUE, WED, THU & FRI Close Registration Closed Dec 15, 16, 17, 18 - 2021 WED, THU, FRI & SAT Close Registration Closed Mar 09, 10, 11, 12 - 2022 WED, THU, FRI & SAT Close Registration Closed Apr 27, 28, 29, 30 - 2022 WED, THU, FRI & SAT Close Registration Closed Jun 29, 30, Jul 01, 02 - 2022 WED, THU, FRI & SAT Close Registration Closed Aug 24, Dec 27, 26, 27 - 2022 WED, TUE, FRI & SAT Close Registration Closed Oct 19, 20, 21, 22 - 2022 WED, THU, FRI & SAT Close Registration Closed Apr 05, 06, 07, 08 - 2023 WED, THU, FRI & SAT Open   Select Jun 14, 15, 16, 17 - 2023 WED, THU, FRI & SAT Open   Select Aug 16, 17, 18, 19 - 2023 WED, THU, FRI & SAT Open   Select Oct 18, 19, 20, 21 - 2023 WED, THU, FRI & SAT Open   Select Dec 13, 14, 15, 16 - 2023 WED, THU, FRI & SAT Open   Select
Module III - Microscope Training Course by Dr.GopiKrishna Oct 08, 09 - 2016 SAT, SUN Close Registration Closed Jan 27, 28 - 2017 FRI, SAT Close Registration Closed Apr 30, May 01 - 2017 SUN, MON Close Registration Closed Aug 25, 26 - 2017 FRI, SAT Close Registration Closed Nov 19, 20 - 2017 SUN, MON Close Registration Closed Mar 16, 17 - 2018 FRI, SAT Close Registration Closed May 24, 25 - 2018 THU, FRI Close Registration Closed Jun 28, 29, 10 - 2018 THU, FRI & MON Close Registration Closed Sep 06, 07 - 2018 THU, FRI Close Registration Closed Nov 25, 26 - 2018 SUN, MON Close Registration Closed Apr 22, 23 - 2019 MON, TUE Close Registration Closed Jun 23, 24 - 2019 SUN, MON Close Registration Closed Sep 22, 23 - 2019 SUN, MON Close Registration Closed Oct 13, 14 - 2019 SUN, MON Close Registration Closed Apr 19, 20 - 2020 SUN, MON Close Registration Closed Oct 25, 26 - 2020 SUN, MON Close Registration Closed Jan 23, 24 - 2021 SAT, SUN Close Registration Closed May 16, 17 - 2021 SUN, MON Close Registration Closed Dec 08, 09 - 2021 WED, THU Close Registration Closed May 07, 08 - 2022 SAT, SUN Close Registration Closed Aug 03, 04 - 2022 WED, TUE Open   Select Nov 19, 20, 04 - 2022 SAT, SUN, MON Close Registration Closed May 06, 07 - 2023 SAT, SUN Open   Select Aug 03, 04 - 2023 THU, FRI Open   Select
Module I - ESTHETIC COURSE by Dr.Deepak Mehta , Dr.Aby Abraham , Dr.Lakshmi May 30, 31, Jun 01 - 2019 THU, FRI, SAT Close Registration Closed Sep 05, 06, 07 - 2019 THU, FRI, FRI Close Registration Closed Mar 12, 13, 14 - 2020 THU, FRI, SAT Close Registration Closed Nov 11, 12, 13 - 2022 FRI, SAT, SUN Close Registration Closed Mar 08, 09, 10, 11 - 2023 WED, THU, FRI & SAT Close Registration Closed Jul 12, 13, 14, 15 - 2023 WED, THU, FRI & SAT Open   Select Nov 15, 16, 17, 18 - 2023 WED, THU, FRI & SAT Open   Select
Module III - INSTRUMENT RETRIEVAL COURSE by Dr.Zaher Al-Taqi Jul 29, 30 - 2022 FRI, SAT Close Registration Closed Jul 21, 22 - 2023 FRI, SAT Open   Select
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