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Scientific Session
November 26 – December 1, 2010

Exhibit Hall Opens:
November 28 – December 1, 2010
9:30am – 5:30pm each day
Wednesday, December 1, 2010
9:30am – 5:00pm

Executive Headquarters Office
Greater New York Dental Meeting
570 7th Avenue, Suite 800
New York, NY 10018
Tel. (212) 398-6922
Fax (212) 398-6934
e-mail: info@gnydm.com

Jacob K. Javits Convention Center
655 West 34th Street
New York, NY 10001

© 2000-2010 Greater New York Dental Meeting
Website by Brainstorm, Inc..

Exhibitor Information Verification Form

Please use the following form. It is needed to insure the accuracy and spelling of your company's submitted information. This information will go into our website and onto our printed material. This is not a substitue for your application form. You still must complete the "formal application" that was sent to you or that you downloaded from this website. This verification form must accompany your application along with a check for the proper payment.

Please follow these instructions:
1. Fill in all information. All areas are required.
2. When you have completed the form with the proper information, press the "Submit" button.
3. The completed form will be sent to the GNYDM Exhibits Desk for our records.
4. You will immediately receive confirmation on your browser that the form was delivered.
5. Finally, you must print this confirmation form and attach it to your application form.

   
Company Name
Address
City
State/Provence
Country
Zip/Postal Code
Company E-mail
Website
Customer Service Telephone
Numerals only - (no “(” or “-” allowed)
Customer Service Fax
 Numerals only - (no “(” or “-” allowed)
Exhibit Contact Person
Contact Person Title
Contact Person E-mail
Contact Person Telephone
 Numerals only - (no “(”or “-” allowed)
Contact Person Extension
 Numerals only - “0” if no extension
Contact Person Fax
 Numerals only - (no “(”or “-” allowed)
Advertising Contact Person
Advertising Contact Person E-mail
Advertising Contact Telephone
Numerals only - (no “(” or “-” allowed)
Advertising Contact Extension
 Numerals only - “0” if no extension

       (All Fields Are Required)

 


Co-sponsored by the Second District Dental Society
and the New York County Dental Society,
components of the American Dental Association.

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