Application/Contract for Membership Event Sponsorship Opportunities

Application/Contract for Membership Event Sponsorship Opportunities

Thank you for your interest in sponsoring a WCDDA event. Our goal is to bring our members together in a social setting for networking opportunities. Throughout the year, WCDDA will hold social events targeting different groups.

Company Information
Date

Month Day Year
Date
Official Company Name *
General description of the equipment, supplies and processes services to be featured. *
Contact Name *

First Name Last Name
Direct Phone *

Area Code Phone Number
E-mail *
Company Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Credit Card Payment Options (do not select if paying by check)

Target Group Event $ 500.00

See description above

Annual or Summer Meeting Reception $ 1,000.00

See description above

Top Golf $ 1,500.00

See description above

Please leave the information above blank if you are paying by check. Checks are made payable to West Coast District Dental Association.

Mail, Fax, or Email: West Coast District Dental Association

1114 Kyle Wood Ln, Brandon, FL 33511

Ph: (813) 654-2500 Fax: (813) 654-2505

Email: Kelsey@wcdental.org
All companies applying for sponsorship opportunities must complete and submit an Application/Contract for Sponsorship Opportunities. WCDDA will not accept application that are not properly completed with signature, deposit, and contact names. Payment can be made by check or credit card.

At this time, signature below indicates an agreement to pay the amount stated, representing the total cost for sponsorship opportuntities requested. It is furhter understood that no money will be refunded, and only credit toward other West Coast events and services will be given.
Name of Signer

First Name Last Name
Signature

Clear
Questions? Contact the WCDDA at lissette@wcdental.org / (813) 654-2500
Should be Empty: