Invisalign Grad Pack Registration CONGRATULATIONS ON YOUR GRADUATION! AS PART OF THE INVISALIGN GRAD PACK, YOU ARE ELIGIBLE TO RECEIVE YOUR FIRST THREE (3) INVISALIGN FULL CASES AT A REDUCED RATE OF $990 PER CASE. OFFER IS ONLY VALID IF YOU SUBMIT AND ACCEPT THE CLINCHECK TREATMENT PLANS ON YOUR INVISALIGN DOCTOR SITE WITHIN NINETY (90) DAYS OF ACCOUNT ACTIVATION. THEREFORE, WE RECOMMEND ACTIVATING YOUR INVISALIGN ACCOUNT AFTER YOU HAVE AT LEAST ONE PATIENT READY FOR TREATMENT. ALL REGISTRATIONS ARE SUBJECT TO VERIFICATION OF ELIGIBILITY. * = Required First Name * Last Name * Email * Residency * Select One Alabama University of Alabama School of Dentistry California Loma Linda University School of Dentistry University of California Los Angeles School of Dentistry University of California San Francisco School of Dentistry University of Southern California School of Dentistry University of the Pacific School of Dentistry Colorado University of Colorado, School of Dentistry Connecticut University of Connecticut School of Dental Medicine Florida University of Florida College of Dentistry Georgia Medical College of Georgia, School of Dentistry Illnois University of Illinois School of Dentistry Indiana Indiana University School of Dentistry Kentucky University of Kentucky School of Dentistry University of Louisville School of Dentistry Massachusetts Boston University School of Dental Medicine Harvard School of Dental Medicine Tufts University School of Dental Medicine Minnesota University of Minnesota School of Dentistry Mississippi University of Mississippi, School of Dentistry Nebraska Creighton University School of Dentistry University of Nebraska Medical Center New Jersey University of Medicine and Dentistry of New Jersey New York Columbia Presbyterian Medical Center School of Dental and Oral Surgery New York University College of Dentistry School of Dental Medicine, SUNY at Stony Brook University at Buffalo School of Dentistry University of Rochester School of Medicine & Dentistry North Carolina The University of North Carolina at Chapel Hill, School of Dentistry Ohio Case Western Reserve University School of Dentistry Ohio State University, School of Dentistry Oklahoma University of Oklahoma School of Dentistry Pennsylvania University of Pennsylvania School of Dentistry South Carolina Medical University of South Carolina Tennessee Meharry College of Dentistry Texas Baylor College of Dentistry University of Texas Health Science Center at San Antonio University of Texas - Houston Dental Branch Washington University of Washington School of Dentistry Washington D.C. Howard University West Virginia West Virginia University School of Dentistry Canada McGill University University of Alberta University of British Columbia University of Manitoba University of Montreal University of Toronto University of Western Ontario Other If Other, please enter program name Which specialty(if applicable)? Orthodontics & Dentofacial OrthopedicsDental Public HealthEndodonticsOral & Maxillofacial PathologyOral & Maxillofacial RadiologyOral & Maxillofacial SurgeryPediatric DentistryPeriodonticsProsthonticsOther If Other, please enter specialty Graduation Date * Select Month January February March April May June July August September October November December / Select Year 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 License Number * State/Region * Invisalign Training Date * Location * Primary Practice Start Date * Office Name * Address * City * State * Zip * Website Phone * Fax Secondary Practice Start Date Office Name Address City State Zip Website Phone Fax Eligibility: This offer applies only to recent graduates from accredited dental specialty residency programs in North America where Invisalign training has been integrated into the teaching curriculum. Your Invisalign Doctor Site account username and password and promotional information will be sent to the email address provided. You will receive an Invisalign Newly Certified Kit within a few weeks at the primary practice address provided. Account set-up will take 7 to 10 business days from the time that you submit this form. I agree to the Terms of Use. LEGAL TERMS & CONDITIONS Any participating doctor who is not in good standing with Align Technology, Inc. is ineligible for this promotion. Treatment submissions and related forms must be completed on-line, using the Invisalign Doctor Site (IDS). Align Technology, Inc. reserves the right to modify or terminate this promotion at any time. Only practices in North America are eligible. Offer cannot be combined with any other Align offer or promotional program. Void where prohibited.
