2025 Summer Meeting Registration Form

2025 Summer Meeting Registration Form

August 8-9, 2025 Wyndham Grand Orlando Resort Bonnet Creek
PLEASE NOTE: THE AIRWAY MANAGEMENT COURSE IS AT CAPACITY.

PLEASE NOTE: THE HANDS ON WORKSHOP IS AT CAPACITY.

BUSINESS MEETING/LUNCHEON IS AT CAPACITY. Please check at FAP meeting registration desk for any cancellations during the meeting.

PLEASE CONTACT THE FAP AT FAP@TAMPABAY.RR.COM TO BE WAITLISTED. Thank you.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select all appropriate registration categories. The Airway Management and hands-on workshop is currently at capacity. Please contact the FAP to be waitlisted: fap@tampabay.rr.com. *
prevnext( X )
FAP Member (active, life, retired)
$100.00 Quantity



Periodontist, Not an FAP Member
$350.00 Quantity



Referring Dentist (GP/non-specialist)
$200.00 Quantity



Perio Resident/Dental Student
$50.00 Quantity



Total

$0.00
Names of Dental Team Members and/or Referring Dentists
Please indicate below dental team member name or referring dentist and what they will be attending. If you need more to add more information, contact the FAP office. Thank you.

Examples:

Linda Smith, RDH Airway Only

Jane Williams, Surgical Asst. - Saturday Lecture/HOW

Dr. John Smith, Referring Dentist, Airway, Friday/Saturday Lectures
Name/Attending
Name/Attending
Name/Attending
Name/Attending
Name/Attending
Dentists: I am attending:*

Friday Dr. Miron LectureSaturday Dr. Miron Lecture
Other Information

Please email or telephone the FAP with any additional team member names, fap@tampabay.rr.com 352-232-6800 or with questions.

Friday - Lunch is on your own.

Saturday - Dentists attend the business meeting/luncheon (see above). Only those indicating they will attend the luncheon/business meeting will receive a ticket.

Dental Team Members lunch on their own.

Paying by credit card? Use the link below. After putting in you credit card via the link and submitting, close out that page, and return to this form and submit.

Want to pay by check? Remit to: FAP and mail: 30524 Birdhouse Drive, Wesley Chapel, FL 33545.
CLICK HERE TO SUBMIT CREDIT CARD PAYMENT.

Close out payment window when credit card transaction is complete and return to this form to sign and submit.

Thank you.
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2025 Summer Meeting Registration Form

Names of Dental Team Members and/or Referring Dentists