Refer a Local Sponsor

Local Chapters participating in the Chapter of the Year program can earn 10 points for each NEW sponsor/exhibitor referred to the national association. If you have a company or business you believe would be a potential new sponsor and/or exhibitor for AADOM, please complete the information below and if the business is determined to meet the criteria of a new sponsor/exhibitor, 10 points will be awarded to your chapter. Contact us at info@dentalmanagers.com if you have any questions.

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New Sponsor or Exhibitor Chapter Referral

Refer your local sponsors to AADOM.
Date*
MM slash DD slash YYYY
Your Name*
First Last
Phone*
Email*
I am an AADOM Chapter Member*
- Yes
- No
Chapter Name*
What is your role with the Chapter?*
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Company Name of Potential Sponsor/Exhibitor*
Product or service provided by potential sponsor/exhibitor:*
Company contact name:*
First Last
Contact phone:*
Contact email:*
Please provide detailed information about your interaction with this company:*
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Refer a Local Sponsor

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