CDAMEX 2026 Registration Form

សន្និសីទ និង ពិព័រណ៍ទន្តសាស្ត្រ នៃសមាគមទន្តពេទ្យកម្ពុជា ប្រចាំឆ្នាំ ២០២៦ (CDAMEX 2026)
Event Details:
Date: March 19th-20th, 2026
Time: 7:00 AM - 5:00 PM
Venue: Sokha Hotel, Phnom Penh Dentistry, Meeting & Exhibition

Benefits:
- Receiving 10 CPD Points.
- Receive cashback coupon* that value up to 30 USD which you can purchase at booths in our conference.
- Receive full access for tea break refreshment along with the lunch buffet** for two days.
- Receive certificate of participation.

*Get cashback coupon value 20 USD for registration between 8th Jan 2026 to 9th Feb 2026.
*Get cashback coupon value 10 USD for registration from 10th Feb 2026 onwards.
**Lunch buffet won't be provided to Dental Student registration, along with the coupon as well.

NOTE: In the time of our Nation Border Crisis, 10$ from your Rehistration Fee will be donated to our 1st line soldiers & refugee at our border in order to show your support as Khmer Citizens to Khmer Soldier. Thank You!

Contact:
- អាន សុភាវី | LOC | Telegram: 088 5898330
- ឆឺយ ដានិ | LOC | Telegram: 096 3424335
- ហួរ លីហួត | LOC | Telegram: 096 4096428
ឈ្មោះជាភាសាខ្មែរ / Full Name in Khmer:*
ឈ្មោះជាភាសាឡាតាំង / Full Name in Latin:*
ភេទ / Gender:*

ស្រី / Femaleប្រុស / Male
លេខទូរស័ព្ទ / Phone Number:*
Please provide a valid phone number or Telegram number for contact purposes
ប្រភេទនៃការចុះឈ្មោះ / Category of Registration:*

ទន្តបណ្ឌិតជាសមាជិក (CDA Membership Dentist)ទន្តបណ្ឌិតមិនមែនជាសមាជិក (CDA Non-membership Dentist)ទន្តបណ្ឌិតបរទេសជាសមាជិក (CDA Membership International Dentist)ទន្តបណ្ឌិតបរទេសមិនមែនជាសមាជិក (CDA Non-membership International Dentist)ទន្តនិស្សិត (Dental Student)
Upload វិញ្ញាបនបត្រថ្នាក់ទន្តបណ្ឌិត រឺកាតនិស្សិត / DDS Certificate or Student ID Card:*

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Maximum file size: 5 MB Cancelof
Upload វិក្កយបត្របង់ប្រាក់ / Payment Invoice:*

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សូមស្កេន QR Code នេះ ដើម្បីបង់ថ្លៃចុះឈ្មោះ
កុំភ្លេចបញ្ចូលវិក្កយបត្របង់ប្រាក់របស់អ្នក
Please scan this QR code to complete your registration fee payment
Don’t forget to upload your payment receipt afterwards
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សន្និសីទ និង ពិព័រណ៍ទន្តសាស្ត្រ នៃសមាគមទន្តពេទ្យកម្ពុជា ប្រចាំឆ្នាំ ២០២៦ (CDAMEX 2026)