MEETING MATERIALS REQUEST FORM
Date requested
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Month
-
Day
Year
Date
Requested delivery date
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Month
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Day
Year
Date
Dates of meeting
Name of meeting
REQUESTOR
Contact Name
*
First Name
Last Name
Distributor
Email
example@example.com
Phone Number
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SHIPPING ADDRESS
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
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State
Zip Code
Phone Number
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Fax Number
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ITEMS NEEDED
ITEMS NEEDED
Quantity
Standard 6’-8’ Table Setup (Includes one (1) each Acrylic Hip and Acrylic Knee model, one (1) Klassic® Blade Stem Pull-up Banner, one (1) Klassic® Knee System Pull-up Banner, one (1) Klassic HD® Hip System Framed Photo, one (1) Klassic® Knee System Framed Photo, one (1) Black Tablecloth (Banquet), one (1) White Tablecloth (square))
Instrument Set – Klassic HD® Hip System
Instrument Set – Klassic® Knee System
Lanyard
Small Notepads
Pens
Black Tablecloth: Round
Black Tablecloth: Square
Black Tablecloth: Banquet
White Tablecloth: Round
Upcoming Meeting Flyers (set of 25)
NOTES/SPECIAL INSTRUCTIONS
SHIPPING OPTIONS
Express Saver (Standard)
Fed-Ex Standard Overnight
Fed-Ex Saturday Delivery
Fed-Ex 2nd Day
Fed-Ex Priority Overnight
Delivery confirmation
IMPORTANT
Please return all items within three (3) days after the meeting ends. By signing below you are acknowledging that you accept all responsibility for the proper care, use, and handling of these items while in your possession. Damaged or missing items will be billed to you.
Name (print)
Signature
Date
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Year
Date
Continue
Continue
TOTAL JOINT ORTHOPEDICS
MISSION-DRIVEN™
1567 East Stratford Ave.
Salt Lake City, Utah 84106
o. 888.890.0102 f. 801.486.6117 sales@tjoinc.com
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