2025 Vendor and Sponsorship Application

7th NCDHA Annual Session Vendor and Sponsor Registration Form

September 12-13, 2025
Thank you for your support!
Meeting Information

September 12-13, 2025

Embassy Suites by Hilton Raleigh-Durham/Research Triangle
201 Harrison Oaks Boulevard
Cary, NC 27513

Exhibit Hall Hours:

Friday, September 12: 9am-8pm

Saturday, September 13: 9am-12pm

**Please note vendors are not expected to be available at their booth the entire day on Friday, but we ask that you set up by 9am Friday and do not break down until 12pm Saturday. There will be a happy hour hosted in the exhibit hall Friday evening. It would be beneficial to be available during that time, but it is not required.

Company Information
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Fax Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact Person: All correspondence for this meeting will be routed to this person *

First NameLast Name
Contact Cell Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email*
example@example.com

Exhibitor Tables

A table is included in all Sponsorship options, but is not required. If you only wish to donate to our Annual Session and do not plan on attending the event please select "no" for the question below.
YesNo
Table sharing is not permitted unless approved by NCDHA. If you are the distributor for a manufacturer, one (1) representative from the manufacturing company at your table will not be considered table sharing. Annual Session Committee reserves the right to refuse contract if it does not fit with purpose of the meeting. Please list the names of persons representing your company by staffing your exhibit space during the trade show. Exhibitors may not register dentists, DA’s, RDH’s or other individuals as exhibitors unless they are employed by or are representing your company for the sole purpose of staffing your table. Only registered exhibitors are allowed in the exhibit hall or in the general area of the Annual Session meeting. Violators of this policy will be dismissed from the meeting and not allowed to participate in future meetings.
Yes and I understand this will incur additional charge of $50No
Table Representative #1: Trade show contact (responsible for exhibit table)
Name*

First NameLast Name
Email*
example@example.com
Cell Phone *
Please enter a valid phone number.Format: (000) 000-0000.
Table Representative #2
Name

First NameLast Name
Email
example@example.com
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Table Representative #3
Name

First NameLast Name
Email
example@example.com
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Table Representative #4
Name

First NameLast Name
Email
example@example.com
Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Please list an competitors that you prefer not to be located near:
Total Exhibitor Table

Additional Exhibitor Information
Please list any door prizes to be given away on Friday
the NCDHA mini rafflesthe NCDHA silent auctionI prefer to give my door prizes away at my table
Please list any door prizes to be given away on Saturday
the NCDHA mini rafflesthe NCDHA silent auctionI prefer to give my door prizes away at my table
Friday ADDITIONAL lunch tickets - $45 per ticket (Please review the sponsorship page of the prospectus to determine the number of lunch tickets already included)
Number of tickets to purchase
Saturday ADDITIONAL lunch tickets - $45 per ticket (Please review the sponsorship page of the prospectus to determine the number of lunch tickets already included)
Number of tickets to purchase
Additional Lunch Tickets Total
Total=Number of Additional Lunch Tickets X $45
Friday ADDITIONAL Hygiene Happy Hour Tickets - $30 per ticket (Please review the sponsorship page of the prospectus to determine the number of Hygiene Happy Hour tickets already included)
Number of tickets to purchase
Additional Hygiene Happy Hour Tickets Total
Total=Number of Additional Hygiene Happy Hour Tickets x $30
"Half the Pot" tickets - a book of 6 tickets is $5. Help us grow the pot early. Tickets will also be available for sale on site!
Please enter the number of books you would like to purchase
Name for Tickets
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
"Half the Pot" Total
Total=Number of Books X $5
Mini Raffle tickets - a book of 6 tickets is $5. Tickets will be placed in your exhibitor packet for you to place in the drawings onsite.
Please enter the number of books you would like to purchase
Name for Tickets
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mini Raffle Total
Total=Number of Books X $5
Total for Extras

Terms and Conditions

Please review the entire pdf exhibitor prospectus before proceeding
I have read and agree to all the terms and conditions outlined in the 7th Annual Session Exhibitor Prospectus
Signature*

Payment Information
Exhibitor Registration Subtotal
pay my exhibitor registration fee onlinemail a check to the NCDHA office
Please be advised that the check MUST be received within 10 business days of receiving your exhibitor application in order to reserve your table.
YesNo
Credit Card Fee Donation Total
Exhibitor Registration Final Total

Should be Empty:

7th NCDHA Annual Session Vendor and Sponsor Registration Form

Thank you for your support!

Company Information

Vendor and Sponsorship Information

Exhibitor Tables

Additional Exhibitor Information

Terms and Conditions

Payment Information

Credit Card