Robert T. Freeman Dental Society Med-Dent Lecture and Vendor Fair
REGISTRATION FORM
I would like to register for the RTFDS Med-Dent Lecture and Vendor Fair at Howard University College of Dentistry on Friday, June 20, 2008. The registration fee for each registrant is $50.00.
Print name EXACTLY as it should appear on your name badge
Name MD DDS DMD
Address
City State Zip Code
Telephone Fax
Payment Method: ____ Check ____ AmExp ____ Visa ____ MasterCard
Name
(as it appears on card)
Address
(address where statement is mailed)
City State Zip Code
Card Number Expiration Date
Signature
Make checks payable to RTF Dental Society
Mail all payments to: Attention: RTFDS Med-Dent Program Committee
Robert T. Freeman Dental Society
3517-16th Street, NW
Washington, DC 20010
301.474.9166 (fax)
Robert T. Freeman Dental Society Med-Dent Lecture and Vendor Fair
VENDOR’S AGREEMENT
We would like to reserve table top exhibit space for the RTFDS Med-Dent Lecture and Vendor Fair at Howard Univerity College of Dentistry on Friday, June 20, 2008.
List name EXACTLY as it should appear on the program
Company Name
Division of (if applicable )
Contact Name
Mailing address
City State Zip Code
Telephone Fax
SPACE FEE: $500.00 per (6) foot draped table
We agree to pay the sum of $500.00 as rental for each space requested by us. We understand payment must be made in full and received by June 9, 2008 to ensure a program listing and space assignment.
Payment Method: ____ Check ____ AmExp ____ Visa ____ MasterCard
Name (as it appears on card)
Card Number Expiration Date
Signature
Make checks payable to RTF Dental Society
Mail all payments to: Attention: RTFDS Med-Dent Program Committee
Robert T. Freeman Dental Society
3517-16th Street, NW
Washington, DC 20010
301.474.9166 (fax)
April 29, 2008
Name
Title
Company
Address
City/State/Zip
Dear Name:
You are invited to participate in a Medical-Dental Joint Continuing Education Seminar and Vendor Fair scheduled for Friday, June 20, 2008. The program is co-hosted by the Robert T. Freeman Dental Society and the Howard University College of Dentistry. The event will be held at the Howard University College of Dentistry, 600 W Street, NW, Washington, DC, from 4:00 pm until 8:00 pm in the 5th Floor Lecture Hall.
The cost for vendor participation is $500.00. Proceeds will benefit the National Dental Association Student Scholarship and Program Development Fund. Participants are asked to set-up six foot table top displays that will showcase products, equipment, services, etc. This event will provide an opportunity for 20 (twenty) selected vendors to expand their customer base and personally meet local health providers.
Eighty to one hundred dentists and physicians are expected to attend. There will be a dinner buffet, and a “Meet and Greet” set-up in the vendor exhibit area from 4:00 – 6:00 pm. The lecture will begin at 6:00 pm. Vendors are invited to be our guests for dinner as well as to attend the lecture and speak to doctors following the lecture, if desired.
In order to reserve your space, please complete the attached registration form and return it with your payment. Registration forms should be mailed to the attention of Dr. Cynthia Worsley, Robert T. Freeman Dental Society, 3517-16th St., NW, Washington, DC, 20010, not later than June 9, 2008.
For additional information or assistance, please call me at 202.291.4500 or e-mail me at .
Thank you for your interest and support of the membership of the Robert T. Freeman Dental Society.
Sincerely yours,
Hazel J. Harper, DDS, MPH
Med-Dent Program Committee
Enclosure