2024 Registration Confirmation I,(Required) Dr. Dr. First Last wish to register with the following status. (Select one of the registration options)Full Practice Register Full Practice Register Fees are for those applying to register between January 1 to June 30. For applicants who have been previously registered in another North American or International jurisdiction. $1,000 registration fee TBD – PLIP costs applicable to annual quarter, and $3,310 practice permit fee Full Register - Half Year Full Register - Half Year Fees are for those applying to register between July 1 to December 31. For applicants who have been previously registered in another North American or International jurisdiction. $1,000 registration fee TBD – PLIP costs applicable to annual quarter, and $2,100 practice permit fee New Graduate (January 1 to May 30) New Graduate (January 1 to May 30) Fees are for those applying to register between January 1 to May 30. For those who have not been previously registered in another jurisdiction (North American or International) $1,000 registration fee TBD – PLIP costs applicable to annual quarter, and $3,310 practice permit fee New Graduate – (June 1 – December 31) New Graduate – Half Year (June 1 – December 31) Fees are for those applying to register between June 1 – December 31. For those who have not been previously registered in another jurisdiction. $1,000 registration fee TBD – PLIP costs applicable to annual quarter, and $2,100 practice permit fee Registered Only Registered Only Available for those that are not planning to practice right away. Note: Certificate of Standing (CoS) or Letters of Good Standing (LoGS) will stale-date 8 weeks from the date of issuance. It is the responsibility of the applicant to ensure that any CoS or LoGS are current at the time of full practice registration. $1,000 registration fee Professional Liability Insurance Program (PLIP) Cost per quarter January – March: $1,415 April – June: $1,061 July – September: $707 October – December: $353Specialist Specialist Specialist registrations will be assessed a one-time Specialist registration fee of $300.00.This one-time fee is in addition to the registration and practice permit fees. A One time Fee of $300 Declaration(Required) I agree to the privacy policy.The calendar year in Alberta is January 1 to December 31. All fees paid are non-refundable and subject to change, based on Council decision. By submitting this form electronically, I acknowledge and agree that the contents are true and complete as if I had signed the document in writing. I declare that the contents of this form are true and complete and I understand and agree that if I make a false or misleading statement or representation in my registration, I will be deemed to have not satisfied the requirement of registration. I further understand agree that making a false or misleading statement to the College of Dental Surgeons of Alberta may constitute unprofessional conduct. Date(Required) MM slash DD slash YYYY