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Exhibitor 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.

Exhibiting at 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. Register online now using debit or credit card.  Fill out the form below and click "Add to Cart".   Click here to download description of Exhibitor 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
Exhibitor Payment Information - Program Book Information must be received by: SEPTEMBER 3, 2010
Platinum Exhibitor Fee $2500
GOLD Exhibitor Fee $2000
NNOHA Advisory Committee Member Exhibitor Fee $1000
NNOHA Non-Member Exhibitor Fee $1500
Non-Profit Exhibitor Fee $ 750
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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