2012 2nd Annual High Altitude Bone Management Winter Camp

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1 2012 2nd Annual High Altitude Bone Management Winter Camp High Altitude Bone Management Winter Camp March 7 th - 10 th, 2012 Jackson Hole, Wyoming

The Venue Jackson Hole Terrain: 2 mountains, Apres

per hour 2,500 acres of in-bounds terrain Open

4,139 feet over 3000+ acres (greatest continuous

) 50% expert trails Base elevation: 6,311

2 The Venue Jackson Hole Terrain: 2 mountains, Apres Vous and Rendezvous Uphill capacity: 12,096 skiers per hour 2,500 acres of in-bounds terrain Open backcountry gate system accesses Vertical drop of 4,139 feet over acres (greatest continuous rise in U.S.) 50% expert trails Base elevation: 6,311 feet/1924 meters 40% intermediate trails Summit elevation: 10,450 feet/3185 meters 10% beginner trails

The Course The Event Renowned Speakers World Famous Location Relevant and Cutting

Bone Management is key to successful implant procedures.

Besides the prosthetic aspect, achieving minimally invasive surgical techniques,

procedures and techniques including: ridge expansion, connective tissue grafting,

Bone Management is not simply limited to a technique but rather to a mindset and

3 The Course The Event Renowned Speakers World Famous Location Relevant and Cutting Edge Presentations Hands-on Workshops Skiing, Snowmobiling Case Study s The Course Bone Management is key to successful implant procedures. Tissue is the Issue but Bone sets the Tone. Besides the prosthetic aspect, achieving minimally invasive surgical techniques, along with predictable results, facilitates less traumatic and more controlled surgical procedures. This course outlines implant treatment planning, site preparation, surgical procedures and techniques including: ridge expansion, connective tissue grafting, bone grafting, esthetic zone implants, CT imaging, and much more. Bone Management is not simply limited to a technique but rather to a mindset and surgical guidelines. This year the course can be chosen as a semi all-inclusive event or a la carte. See the registration form for the details. All attendees receive the opening wine and cheese reception, lecture entrance, and participation in the case study evening event.

General Information Information: Venue: Four Seasons Resort 7860 Granite Loop Road, Teton Village, Wyoming 83025 Telephone 800-295-5281 and/or 307-732-5075 Limited Attendance: 100 attendees

Scott Ganz, DMD (limited to 25 attendees) Abstract: The use of CBCT has forever changed the manner in which clinicians can appreciate individual patient anatomy.

block grafting, etc., has been exponentially enhanced through interactive treatment planning software. This program is designed to demonstrate several different software applications available today.

4 General Information Information: Venue: Four Seasons Resort 7860 Granite Loop Road, Teton Village, Wyoming Telephone and/or Limited Attendance: 100 attendees Pre-Symposium Workshops: Diagnosis and Treatment Planning for Bone Grafting and Site Preparation for Dental Implants: Utilizing CBCT and Interactive Software to Enhance Results! Presented by Dr. Scott Ganz, DMD (limited to 25 attendees) Abstract: The use of CBCT has forever changed the manner in which clinicians can appreciate individual patient anatomy. The ability to visualize potential implant receptor sites, bone topography for ridge-splitting, the three dimensional assessment of the maxillary sinus, proximity to the inferior alveolar nerve, block grafting, etc., has been exponentially enhanced through interactive treatment planning software. This program is designed to demonstrate several different software applications available today. Soft Tissue Grafting for the Implantologist Presented by Dr. Robert Gellin, DMD, MHS (limited to 25 attendees) Abstract: This discussion will be divided into a lecture and a hands-on component. The focus will be on the free gingival graft and the connective tissue graft. The objective is for the participant to have a clearer understanding of the differences between these two procedures regarding definition, indications, contraindications, surgical techniques, and expected outcomes. The procedures will be demonstrated and several Periodontists/faculty will provide one-on-one instruction in the surgical technique on prepared specimens. Special instruments for soft tissue grafting will be demonstrated and provided for use in the hands-on laboratory. Speakers: Dr. John Russo, DDS, MHS Dr. Robert Gellin, DMD, MHS Dr. Scott Ganz, DMD Dr. Istvan Urban, DMD, MD (Hungary) Dr. Eric Hamrick, DMD Dr. Giles Horrocks, DDS, MS Dr. Daniel Cullum, DDS Dr. Stavros Pelekanos, DDS (Greece) (additional information will be provided once registered)

Program Preliminary program: Wednesday, March 7 th, 2012 Pre-Symposium Lectures and Hands-on Workshops 01:00-08:00 pm Registration 02:00-05:00 Dr.

Robert Gellin - Soft Tissue Grafting for the Implantologist (Pig Jaws will be used in this workshop.

Eric Hamrick - A Comprehensive Approach to Socket Grafting 09:30-09:45 Break 09:45-11:15 Dr.

07:45-08:00 Introduction 08:00-09:30 Dr. Daniel Cullum - Osteotome and Contiguous Sinus Elevation 09:30-09:45 Break 09:45-11:15 Dr.

5 Program Preliminary program: Wednesday, March 7 th, 2012 Pre-Symposium Lectures and Hands-on Workshops 01:00-08:00 pm Registration 02:00-05:00 Dr. Scott Ganz - CBCT It s not the Scan; It s the Plan Laptops required 02:00-05:00 Dr. Robert Gellin - Soft Tissue Grafting for the Implantologist (Pig Jaws will be used in this workshop.) 06:00-08:00 Wine and Cheese Reception Thursday, March 8 th, :00-07:45 am Breakfast Buffet 07:50-08:00 Opening Remarks 08:00-09:30 Dr. Eric Hamrick - A Comprehensive Approach to Socket Grafting 09:30-09:45 Break 09:45-11:15 Dr. Giles Horrocks - Controlled Atraumatic Ridge Expansion - When, Where, Why: An Algorithm To Treatment 11:30-01:00 pm Hands-on Workshop - Ridge splitting, Ridge Expansion 05:30-07:00 pm Dr. Istvan Urban - New Perspectives on Vertical and Horizontal Augmentation with Guided Bone Regeneration (GBR) Friday, March 9 th, :00-07:45 am Breakfast Buffet 07:45-08:00 Introduction 08:00-09:30 Dr. Daniel Cullum - Osteotome and Contiguous Sinus Elevation 09:30-09:45 Break 09:45-11:15 Dr. John Russo - Block Allografts and Lateral Window Sinus Grafting 11:30-01:00 pm Hands-on Workshop - Lateral Sinus Window and Block Grafting 05:00-06:30 pm Dr. Stavros Pelekanos - Immediate Function Therapy: When and How 06:30-08:00 pm Case Studies Open bar and appetizers will be provided during case studies. Saturday, March 10 th, :00-07:45 am Breakfast Buffet 07:45-08:00 Daily Report and Introduction 08:00-09:30 Complications Part 1 (Russo, Gellin, Ganz, Cullum) 09:30-09:45 Break 09:45-11:15 Complications Part 2 (Urban, Hamrick, Pelekanos) 01:00-02:30 pm Private Ski Race for all levels 06:00-08:30 Closing Dinner/Awards

Dr. John Russo, DDS, MHS USA John Russo, DDS, MHS is a graduate of The Ohio

He completed his periodontal training and earned a Master in Health

Russo is a Diplomat of the International Congress of Oral Implantologists.

professor at the Medical University of South Carolina in the Division of

He is an author and an international lecturer on bone grafting and dental

Russo serves on the Executive Council for the Southern Academy of

Board of Journal of Clinical and Practical Oral Implantology.

Implantologists Spring Symposium 2010. Dr.

course held at the Medical University of South Carolina.

6 Dr. John Russo, DDS, MHS USA John Russo, DDS, MHS is a graduate of The Ohio State University College of Dentistry. He completed his periodontal training and earned a Master in Health Sciences degree from the Medical University of South Carolina. Dr. Russo is a Diplomat of the International Congress of Oral Implantologists. He is in private practice in Sarasota, FL, and is a clinical assistant professor at the Medical University of South Carolina in the Division of Periodontics. He is an author and an international lecturer on bone grafting and dental implant surgery. Dr. Russo serves on the Executive Council for the Southern Academy of Periodontology, Council/Section Editor for Implant Dentistry, and Editorial Board of Journal of Clinical and Practical Oral Implantology. He also served as program chair for the International Congress of Oral Implantologists Spring Symposium Dr. Russo is the course director for a bone and soft tissue hands-on cadaver course held at the Medical University of South Carolina. This course has trained more than 1000 dentists over the past 10 years. Dr. Russo is a consultant/speaker for several dental implant related companies and also holds a patent for the processing of placental tissue used in dentistry. Dr. Russo was recently featured in an episode on the Discovery Channel series Health Heroes.

USA Dr. Robert G. Gellin, DMD, MHS Robert G.

He earned his Certificate in Periodontics and Master in Health Sciences degree in 1985 from the Medical University

Gellin is Professor and Chair of the Department of Stomatology and Director of the Division of Periodontics at the

He has been on the faculty at MUSC since 1985. Dr. Gellin is a Diplomate of the American Board of Periodontology.

Public Health Service including a one-year general practice residency.

Gellin presents didactic lectures and seminars to pre-doctoral students and post-doctoral periodontic residents and

Gellin is the course co-director for the Hands-On Cadaver Course for Bone and Soft Tissue Grafting held at the

7 USA Dr. Robert G. Gellin, DMD, MHS Robert G. Gellin, DMD, MHS is a 1980 graduate of the University of Kentucky, College of Dentistry. He earned his Certificate in Periodontics and Master in Health Sciences degree in 1985 from the Medical University of South Carolina, College of Dental Medicine. Dr. Gellin is Professor and Chair of the Department of Stomatology and Director of the Division of Periodontics at the Medical University of South Carolina (MUSC), College of Dental Medicine. He has been on the faculty at MUSC since Dr. Gellin is a Diplomate of the American Board of Periodontology. Prior to his specialty training in Periodontics, he spent three years in the U.S. Public Health Service including a one-year general practice residency. He maintains an active practice limited to Periodontics within the College s Dental Faculty Practice. Dr. Gellin presents didactic lectures and seminars to pre-doctoral students and post-doctoral periodontic residents and is an attending in the Periodontics Clinic. Dr. Gellin is the course co-director for the Hands-On Cadaver Course for Bone and Soft Tissue Grafting held at the Medical University of South Carolina. He has given numerous presentations to dentists, dental hygienists, and dental assistants for local, state, national, and international dental organizations. In addition, Dr. Gellin is the administrator of the MUSC College of Dental Medicine s clinic management software (axium). As of August 1, 2011, the dental school is chartless in all their clinics. He is on the board of directors for the Consortium for Oral Health Related Informatics.

Dr. Scott Ganz, DMD USA Dr. Scott D. Ganz, DMD graduated from the University of Medicine and Dentistry - New Jersey Dental School.

Ganz is well-published in various scientific and professional journals (over 55 articles).

Computer Utilization for Diagnostic, Graphical, and Treatment Planning Applications in Dentistry. Dr.

Prosthetics, The International Congress of Oral Implantologists, The American College of Prosthodontists, The American Academy of Implant Dentistry, The European Academy of Osseointegration, and The

8 Dr. Scott Ganz, DMD USA Dr. Scott D. Ganz, DMD graduated from the University of Medicine and Dentistry - New Jersey Dental School. He completed a three-year specialty program in Maxillofacial Prosthetics at M.D. Anderson Cancer Center in Houston, Texas. Dr. Ganz is well-published in various scientific and professional journals (over 55 articles). He has delivered presentations both nationally and internationally on the Prosthetic and Surgical phases of Implant Dentistry and is considered one of the world s leading experts in the field of Computer Utilization for Diagnostic, Graphical, and Treatment Planning Applications in Dentistry. Dr. Ganz has been a featured speaker for numerous organizations including the Academy of Osseointegration, American Academy of Oral and Maxillofacial Surgeons, The American Academy of Maxillofacial Prosthetics, The International Congress of Oral Implantologists, The American College of Prosthodontists, The American Academy of Implant Dentistry, The European Academy of Osseointegration, and The American Society of Osseointegration. He currently serves as Associate Editor for the peer-reviewed journal Implant Dentistry and the editorial staff of Practical Procedures and Esthetic Dentistry. Dr. Ganz s book, An Illustrated Guide to Understanding Dental Implants available in both English and Spanish, has received wide acclaim as the standard in patient education texts and has sold worldwide in over fifteen countries. Dr. Ganz is on the implant faculty of many preceptorship programs around the country, is on the staff of Hackensack University Medical Center, was a past faculty member of the University of Pennsylvania Dental School, and is presently on faculty at New Jersey Dental School. Dr. Ganz has served as a consultant for numerous companies involved with dental implants, imaging, and the high technology arena for the past fifteen years. Dr. Ganz is a Past President of the N.J. Section of the American College Dr. of Dr. Prosthodontists Florian G. Draenert and maintains a private practice for Prosthodontics, Maxillofacial Oberarzt Prosthetics, an der Klinik and und Implant Poliklinik Dentistry für Mund-, in New Kiefer- Jersey, und USA. Gesichtschirurgie He also developed and Operationen, maintains an Universitätsmedizin internet FORUM on der interactive Johannes-Gutenberg-Universität; CT scanning technology Mainz. and - plastische was a founding member of the SIMPLANT ACADEMY, headquartered in Lueven, Belgium Tätigkeitsschwerpunkt: ( Implantologie Dr. Ganz und is Knochenaufbau the current President of the Computer Aided Implantology Academy (CAI Academy).

University School of Medicine and Dentistry in 1992 and 1996.

Istvan Hospital in Budapest, Hungary (1992-1996).

After he graduated from the Fellowship Program (1999-2000) in Implant Dentistry at Loma

active license in the state of California.

9 HUNGARY Dr. Istvan Urban, DMD, MD Dr. Istvan Urban, DMD, MD received his DMD degree and subsequently his MD degree from Semmelweis University School of Medicine and Dentistry in 1992 and He completed a residency program in oral surgery at St. Istvan Hospital in Budapest, Hungary ( ). He completed his internship program in Periodontics at UCLA. After he graduated from the Fellowship Program ( ) in Implant Dentistry at Loma Linda University in Loma Linda, California, he was appointed assistant professor the following year. Dr. Urban teaches implant dentistry in the graduate program at Loma Linda, and he holds an active license in the state of California. He maintains a private practice in Budapest, Hungary. Currently, Dr. Urban is conducting several clinical studies about the success of bone augmentation procedures and the long-term success rates of dental implants placed in regenerated bone. He has published several scientific articles and book chapters on the topic of bone regeneration. Dr. Urban is an invited speaker internationally in the field of Implant Dentistry.

He then completed his dental training at the Medical University of South Carolina s College of Dental Medicine, obtaining his Doctor of

Hamrick attended the University of Alabama s Department of Periodontics where he received his Certificate in Periodontics in 1984. Dr.

10 Dr. Eric Hamrick, DMD USA Dr. Eric Hamrick, DMD received his Bachelor of Science degree and graduated Magna Cum Laude from Florida Southern University in He then completed his dental training at the Medical University of South Carolina s College of Dental Medicine, obtaining his Doctor of Dental Medicine in Dr. Hamrick attended the University of Alabama s Department of Periodontics where he received his Certificate in Periodontics in Dr. Hamrick is Board Certified by the American Board of Periodontology and is a Diplomate of the American Board of Oral Implantology and Implant Dentistry. He has extensive experience in periodontal therapy, cosmetic periodontal surgery, preprosthetic surgery, dental implant therapy, and is a certified Wilckodontics provider. Dr. Hamrick is fully trained and licensed to perform Laser Periodontal Therapy using LANAP (Laser Assisted New Attachment Procedure) for treating periodontal disease. Dr. Hamrick currently serves part-time on the academic faculty of the Medical University of South Carolina s College of Dental Medicine as a Clinical Assistant Professor. He has maintained a private practice in Greenville, South Carolina, for more than twenty-five years. Dr. Hamrick enjoys lecturing locally and nationally on topics including bone grafting, implant-orthodontic-restorative relationships, guided implant therapy, and virtual treatment planning. Dr. Dr. Florian G. Draenert Oberarzt an der Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie - plastische Operationen, Universitätsmedizin der Johannes-Gutenberg-Universität; Mainz. Tätigkeitsschwerpunkt: Implantologie und Knochenaufbau

USA Dr. Giles Horrocks, DDS, MS Giles B.

he completed his specialty training in Periodontology in the Department of

School of He is an Assistant Clinical Professor at the School of Dental

Controlled Assisted Ridge Expansion (CARE).

on advanced piezosurgery and has a recent publication in the International

11 USA Dr. Giles Horrocks, DDS, MS Giles B. Horrocks DDS, MS is a graduate of the University of Oklahoma, College of Dentistry. Following four years of general practice with the Indian Health Service, he completed his specialty training in Periodontology in the Department of Medicine and Surgery at the Veterans Administration Medical Center in Milwaukee, Wisconsin. Dr. Horrocks received a Masters of Science degree from Marquette University School of Dentistry. He is an Assistant Clinical Professor at the School of Dental Medicine at the University of Colorado and is a Diplomate of the American Board of Periodontology. He has spoken nationally and internationally on Advanced Piezosurgery and Controlled Assisted Ridge Expansion (CARE). He has written a chapter on Piezo-Assisted Ridge Expansion in a textbook on advanced piezosurgery and has a recent publication in the International Journal of Periodontics and Restorative Dentistry on the CARE approach to Ridge Expansion. Dr. Horrocks is the past president of the Rocky Mountain Society of Periodontists and is in a private practice in Boulder, Colorado. He limits his practice to Periodontics with a focus on dental implant related surgery.

distinction at the University of Alberta,

Westchester Medical Center, New York. Dr.

He has served in leadership roles with the

he practices Oral and Maxillofacial Surgery

12 Dr. Daniel Cullum, DDS USA Dr. Daniel Cullum, DDS completed his DDS with distinction at the University of Alberta, Canada, and residency training at Westchester Medical Center, New York. Dr. Cullum is a Diplomate of the American Board of Oral and Maxillofacial Surgery. He speaks internationally and has contributed publications and textbook chapters on implant reconstruction. He has served in leadership roles with the American Association of Oral and Maxillofacial Surgeons (Dental Implant Sub-Committee), Academy of Osseointegration (Newsletter Committee), Kootenai Medical Center (Chairman, Department of Surgery), and at state and local societies. At Implants Northwest (Coeur d Alene, ID), he practices Oral and Maxillofacial Surgery with emphasis on immediate and minimally invasive techniques in esthetic implant reconstruction. Dr. Cullum is also president of Implants Northwest LIVE Learning Center which emphasizes training in advanced techniques for surgeon/restorative teams using LIVE surgery and hands-on application in a small group environment.

In 1993, he obtained his doctoral degree in Prosthodontics (Dr med dent) from the

Following his professional training, Dr.

Doukoudakis), and is now Assistant Professor in the same department.

European Academy of Esthetic Dentistry (EAED, affiliate), European Prosthodontic

13 GREECE Dr. Stavros Pelekanos, DDS Dr. Stavros Pelekanos, DDS received his undergraduate degree in Dentistry (D.D.S.) in 1991 from the National and Kapodistrian University of Athens, Greece. In 1993, he obtained his doctoral degree in Prosthodontics (Dr med dent) from the University of Freiburg (Prof. Dr. J.R. Strub), Germany. Following his professional training, Dr. Pelekanos established a private practice in Athens, oriented towards prosthodontics, implantology, and esthetic dentistry. In 2002, he was appointed full-time Lecturer at the Department of Prosthodontics, Dental School, University of Athens, Greece (Director: Prof. Dr. A. Doukoudakis), and is now Assistant Professor in the same department. His professional affiliations include International College of Prosthodontics (ICP), European Academy of Esthetic Dentistry (EAED, affiliate), European Prosthodontic Association (EPA), and Greek Prosthodontic Association. In 2008 in Madrid, Spain, and 2011 in Turkey, Istanbul, Dr. Pelekanos received second and first place respectively at the scientific award competition of the European Academy of Esthetic Dentistry (EAED). To date, he has published over twenty articles and lectures nationally and internationally.

Acts beyond our control that may preclude this course from being held shall not be grounds for a refund Course speakers and

Snake River lodge and spa (A Rock Resort) Rooms are limited at the Four Seasons to the first 75 registrants.

to unforeseen reasons, all monies collected prior to the event will be promptly refunded.

Attendance Fee Information: * Option 1: Includes all main course lectures (Thurs-Sat), buffet breakfasts (Thurs-Sat), opening

* Option 2: Includes 4 nights at the Snake River Lodge and Spa (Wed-Sat), all main course lectures (Thurs-Sat), buffet breakfasts

(Fee $2,995 00 ) * Option 3: Includes 4 nights at the Four Seasons Resort (Wed-Sat), all main course lectures (Thurs-Sat), buffet

Charleston, SC 29425 The Medical University of South Carolina, Department of Stomatology, Division of Periodontics has been using

The MUSC College of Dental Medicine is an ADA CERP recognized provider.

14 Acts beyond our control that may preclude this course from being held shall not be grounds for a refund Course speakers and course sponsors are subject to change The course deposit is non refundable We have secured 50 additional rooms at the adjacent Snake River lodge and spa (A Rock Resort) Rooms are limited at the Four Seasons to the first 75 registrants. Some registrants may be placed at adjacent properties if our block number of rooms is exceeded Should the course be cancelled due to unforeseen reasons, all monies collected prior to the event will be promptly refunded. All registrations must made through Meisinger USA. Attendance Fee Information: * Option 1: Includes all main course lectures (Thurs-Sat), buffet breakfasts (Thurs-Sat), opening reception, and case study evening. (Fee $1, ) *Does not include lodging accommodations. * Option 2: Includes 4 nights at the Snake River Lodge and Spa (Wed-Sat), all main course lectures (Thurs-Sat), buffet breakfasts (Thurs-Sat), opening reception, case study evening, and closing dinner. (Fee $2, ) * Option 3: Includes 4 nights at the Four Seasons Resort (Wed-Sat), all main course lectures (Thurs-Sat), buffet breakfasts (Thurs-Sat), opening reception, case study evening, and closing dinner. (Fee $3, ) 173 Ashley Avenue. Charleston, SC The Medical University of South Carolina, Department of Stomatology, Division of Periodontics has been using cadavers for continuing education in order to teach advanced bone grafting surgical procedures since The MUSC College of Dental Medicine is an ADA CERP recognized provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. The MUSC College of Dental Medicine designates this activity for a maximum of 19 credit hours of continuing education credits, depending on course options taken.

15 Registration Fax Form Tel.: +1 (303) Fax: +1 (303) *Hereby I apply bindingly for the High Altitude Bone Management Winter Camp taking place in Jackson Hole, Wyoming, from March 7 th - 10 th, DDS DMD MD Course fees: Qty: Option 1 $ 1,595 First Name* 00 Total:(from left) Option 2 $ 2, Total:(from left) Option 3 $ 3, Total:(from left) Last Name* Pre-Symposium Workshops (Wed., March 7 th ): Pre-Symposium Workshops are limited to the first 25 registrants per workshop. Practice Address* City/State* Unit/Suite Phone Number (Office )* Phone Number (Cell) Fax * / Billing Zip Code* CBCT Hand-on (2-5pm) Soft Tissue Grafting (2-5pm) $ $ Sub-Total:(from above) Misc. Charges: Total:(from left) Total:(from left) Main Hands-on Workshop (Thurs., March 8 th & Fri., March 9 th ): Main Hands-on Workshops are limited to the first 50 registrants per workshop. Ridge Expansion (Thurs.) $ Total:(from left) Block & Sinus Grafting (Fri.) Ski Race (Sat., March 10 th ) Ski Race $ Closing Dinner (Evening of March 10 th ): (included in options 2 and 3) Price Per Person Person over 18 Person under 18 $ $ Total:(from left) 00 $ 20 Total:(from left) Total:(from left) Total:(from left) I approve that the amount listed be charged to my credit card to be applied as a deposit towards my complete course costs. I will be invoiced for the remainder of the course fees and additional charges as may arise (workshops, room upgrades, special arrangements). One form must be submitted for each registrant. If I choose to pay only the deposit at this time, I understand that the remainder is due on or before December 31st, Failure to pay when due may result in forfeiture of my deposit and course attendance. A non-refundable fee of $ is required to reserve your conference attendance. Additional information will be sent after registration has been accepted. Additional Hotel Nights: 1 We have negotiated special rates for 3 days prior to the course beginning and 3 days after the course ends. The additional nights are the sole responsibility of the attendee and their guests and are NOT part of any offered package. For additional information, please speak directly with a Meisinger representative. Total:(from above) Closing Dinner additional guest(s) information Number of additional guests Additional guest name Additional guest name Banking Information MasterCard Visa American Express Deposit $ or Process full payment (total from above) Credit card number CCV Expiry date *Denotes Required Field Signature*

Sponsors Diamond Sponsors Platinum Sponsors s

7442 South Tucson Way, Suite 130 Centennial,

: +1 (303) 268-5400 Fax: +1 (303) 268-5407

16 Sponsors Diamond Sponsors Platinum Sponsors s rs Gold Sponsors Meisinger USA, L.L.C South Tucson Way, Suite 130 Centennial, Colorado USA Tel.: +1 (303) Fax: +1 (303) info@meisingerusa.com 85KFJH

Dr. Michael A. Pikos

Dr. Michael A. Pikos Dr. Pikos is originally from Campbell, Ohio. He attended The Ohio State University where he graduated Summa Cum Laude and Phi Beta Kappa. He also graduated with honors from The Ohio