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Sponsorship Registration - National Primary Oral Health Conference


Please complete the form below to register online using our secure shopping cart.

When filling out the form below, please do not use any special characters such as apostrophes, commas, or dashes.

If you prefer to pay by check, please click here.


Sponsoring the National Primary Oral Health Conference is an excellent way to show your products and services to the approximately 400 dental and oral health leaders attending the conference.   Click here to download description of Sponsorship opportunities.



About Hotel Reservations
Please contact The Gaylord Palms Hotel in Orlando, FL directly to make your lodging reservations or click here to go directly to Hotel page.

Phone: 407-586-2000. Refer to "National Primary Oral Health Conference" code A-NOHA in order to receive the special conference rate of $154.00

(Single/Double) per night plus 14% tax. Rate and availability guaranteed only until September 23, 2010.


Note: Continuing Education Units (CEU's).  At least 20 CEU's will be offered at the National Primary Oral Health Conference.

PLEASE NOTE - WE ONLY ACCEPT VISA AND MASTERCARD
Sponsorship Payment Information Your sponsorship will be used to cover general conference expenses. Program Book information must be received by: SEPTEMBER 3, 2010
Breakfast Sponsor
None
Monday - $3500
Tuesday - $3500
Wednesday - $3500
Lunch Sponsor
None
Monday - $3000
Tuesday - $3000
Wednesday - $3000
Tee Shirt Sponsor
None
$3000
Prefix
Last Name
First Name, MI
Credentials
Title (no acronyms)
Organization
Address
City
State
Zip Code
Phone
Fax
Participants Email Address
Email address where confirmation should be sent
Exhibitor Category
Region I - ME, NH, VT, MA, RI, CT
Region II - NY, NJ
Region III - PA, MD, DE, VA, WV
Region IV - KY, TN, NC, SC, GA, FL, AL, MS
Region V - MN, WI, IL, IN, MI, OH
Region VI - NM, TX, OK, AR, LA
Region VII - NE, KS, IA, MO
Region VIII - MT, ND, SD, WY, CO, UT
Region IX - NV, CA, AZ, HI
Region X - WA, OR, ID, AK
Speaker
Federal
Note if any other categories apply
Special Dietary Restrictions / Food Allergies
Special Needs
Pre-Registration is required for the following sessions. Choose option to register.
None
None
Exhibitor Needs:
Table, Chairs (number)
Electricity (extra charge)
None
Yes
Phone line (extra charge)
None
Yes
Skirted
None
Yes
Internet Connection (extra charge)
None
Yes
Other (please explain)
NNOHA YEARLY MEMBERSHIP - Join Today!!!
None
RENEW my Membership ($25 per individual)
RENEW my Organizational Membership ($250)
Become a NEW Member ($25 per individual)
Become an ORGANIZATIONAL Member ($250)
Become an Advisory Commitee Member ($2500)
CONFERENCE ACTIVITIES - Choose option to register
None
Annual morning NNOHA "Board" walk
 
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