4901 York Blvd. Los Angeles CA 90042 Exhibit Dates: Phone: (323) 255-5848 Fax: (323) 255-5848 September 7 - September 8, 2012 Hilton Los Angeles/Universal City Universal City, CA $1,000.00 per booth, made payable to Los Ange- country, customer service phone, fax numbers, E-mail and Website address as shown on this form are for use in the Program and Exhibit Guide. Company Name Address City, State/Country, Zip Code Company E-mail Website Customer Service Telephone ( ) Fax Exhibit Contact Person Title E-mail Fax Contact Telephone ( ) Extension E-mail Telephone ( ) Extension Size of Booth Space 8 x 8 Total number of Booths requested Number of Booths x $1000.00 = Total deposit enclosed $ APPLICATIONS RECEIVED WITHOUT FULL PAYMENT PER BOOTH WILL NOT BE PROCESSED. - 1. 2. 3. 4. 5. 6. 7. 8. THE LOS ANGELES DENTAL MEETING DOES NOT ASSUME ANY LIABILITY OR RESPONSIBILITY FOR ANY TYPOGRAPHICAL ERRORS, OMISSIONS OR INACCURACIES OF ANY KIND IN ANY OF ITS PUBLICATIONS. AUTHORIZED SIGNATURE TITLE DATE PRINT FULL NAME APPLICATION/CONTRACT FOR EXHIBIT SPACE LA
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
4901 York Blvd.Los Angeles CA 90042 Exhibit Dates:Phone: (323) 255-5848 Fax: (323) 255-5848 September 7 - September 8, 2012
Hilton Los Angeles/Universal City Universal City, CA
$1,000.00 per booth, made payable to Los Ange-
country, customer service phone, fax numbers, E-mail and Website address as shown on this form are for use in the Program and Exhibit Guide.
Company Name
Address
City, State/Country, Zip Code
Company E-mail Website
Customer Service Telephone ( ) Fax
Exhibit Contact Person Title
E-mail Fax
Contact Telephone ( ) Extension
E-mail
Telephone ( ) Extension
Size of Booth Space 8 x 8 Total number of Booths requested
Number of Booths x $1000.00 = Total deposit enclosed $
APPLICATIONS RECEIVED WITHOUT FULL PAYMENT PER BOOTH WILL NOT BE PROCESSED.
-
1. 2. 3. 4.
5. 6. 7. 8.
THE LOS ANGELES DENTAL MEETING DOES NOT ASSUME ANY LIABILITY OR RESPONSIBILITY FOR ANY TYPOGRAPHICAL ERRORS,
OMISSIONS OR INACCURACIES OF ANY KIND IN ANY OF ITS PUBLICATIONS.