Please enter your credentials (e.g. DDS)

Please enter your cell phone number

Please enter your email address

How long have you been speaking?

Please select any of the programs below that you have attended in the past.

I submit that the above is true and accurate.

What is your speaking TOPIC? This is the SUBJECT of your presentation, such as Practice Management, Periodontal Disease, Implants, Marketing, Infection Control, Oral-Systemic Link, Mental Health, etc. NOT YOUR TITLE. DO NOT WRITE A SENTENCE OR EXPLANATION.

What is the TITLE of your presentation? Keeping the title short is best. **Because we adhere to AGD PACE guidelines, the course title cannot be selling a product or service of any sort.

Type a THREE (3) sentence SUMMARY describing the content of your course. **Because we adhere to AGD PACE guidelines, the course summary cannot be selling a product or service of any sort. If you have ANY questions about your course summary, please contact [email protected] (if longer, we reserve the right to edit content).

Type your biography in fifty (50) words or less. Bios must be in the third party as if someone were introducing you. Content will be edited if it is over 50 words. You will NOT be contacted before editing.

Upload a PROFESSIONAL headshot image here! By uploading, you are agreeing for images to be used in all Dental Festival marketing materials, not limited to print, web, and paid advertisements. Please name your file using your FIRST and LAST name only. Files with any special characters will not be accepted. Please make sure you rename your photos with the appropriate file name. Selfies will not be accepted. It must look professional. Thank you! [upload image 10MB or less, maximum number of files 1] JPEG format only.