Get Smart Registration


	MASTERY OF PRACTICE

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THE MASTERY COMPANY

: REGISTRATION
GET SMART! Program

This is the registration form for the GET SMART! Program. Complete the form and click SUBMIT at the bottom of the page.

PROGRAM COST: $3,600 (6 months at $600 billed to credit card; first payment of $600 reserves your seat in the program)

Listen to Dr. Marc Cooper speak about the GET SMART! program.

Thank you for your interest in the Mastery Company. If you have any questions, please e-mail us or call (425) 806-8830.

		Name *

		Billing Address

		E-mail Address *

		Main Phone Number		Back Line Number

		Cell Phone Number		Home Phone Number

		Year Graduated from Dental School

		Name (Office Manager) *

		E-mail Address (Office Manager) *

COPYRIGHT NOTICE: Elements of the GET SMART! Program may be downloaded for viewing purposes, but may not be used without the prior consent of THE MASTERY COMPANY. Consent may be obtained by registration or by hiring TMC to conduct said program. Use of Mastery of Practice program materials without prior consent is in violation of the Federal Copyright Law [17 USC 101 et seq]. Violators may be subject to criminal penalties as well as liability for substantial monetary damages, including statutory damages of up to $100,000 per infringement, costs and attorney's fees.

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Credit Card Information

Credit Card Type

Credit Card Number (No Spaces)

Expiration Date (08/11)

Credit Card Charges:
Your monthly charge will show up as "MBC Inc." or "The Mastery Company" on your credit card statement.

* Required to submit this form