2025 Annual Session Exhibitor Application

Contact Information:
LEAD: Individual authorized to act on behalf of company/organization, sign contracts, etc.

LOGISTICS: Individual who will register booth staff, manage shipping and booth orders, provide logos, etc.

BILLING: Individual authorized to receive and process invoices on behalf of company/organization.
LEAD Contact*

First NameLast Name
Email
example@example.com
LOGISTICS Contact*

First NameLast Name
Email*
example@example.com
BILLING Contact*

First NameLast Name
Email*
example@example.com

Exhibit Selection:
10x10 Booth in Dental Marketplace $1,800Additional Booth Staff $200
If purchasing badges for additional booth staff, indicate how many:
You also have the opportunity to purchase additional badges at a later date.
Promotional Opportunities:

If you are interested in additional promotion opportuities, refer to the Annual Session Sponsor & Exhibitor Prospectus for more details.
Hotel Room Door Drop $5,000Promo Package $2,000Hotel Check-in Handout $1,000Chair Drop $1,000Attendee Email $1,500
Total amount due to ASDA:*

On behalf of the aforementioned company/organization, I have reviewed the Terms and Conditions and agree to be bound by the same.
Signature*

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Date*

MonthDayYear
Date
To receive a confirmation of this application, provide your email address below:*
example@example.com
Should be Empty: