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RSVP for NC Missions of Mercy Portable Dental Clinic July 18 and 19, 2008 Hosted by Quigless Natural Health Center of Tarboro Contact: Carol Quigless (252) 824-8301 or (252) 824-7300 Fax: (252) 824-8305 99 Main Street Tarboro, NC 27886
Name:________________________________________________________
Address:______________________________________________________
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Telephone:_______________________ Fax:________________________
Email:________________________________________________________
Are you a Dentist?_____ Dental Hygienist?______ Dental Assistant?______
The Clinic will run from 8:00 a.m. until 5:00 p.m. on both days. Lunch will be provided, along with light refreshments throughout the day.
Will you participate on both 7/18 and 7/19?______ What hours?_________
Will you participate on 7/18?______ What hours?_____________________
Will you participate on 7/19?______ What hours?_____________________
Are there colleagues you can refer us to? Please give us names and contact information:
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