China Day Program Application Form

Dear guests,

Thank you for applying to attend China Day Program which will be organized at Nov. 1st in Shanghai World Expo Exhibition & Convention Center. We offer 100 free seats for international buyers based on first come first serve due to limited capacity of VIP lounge.

Thank you for your time and attention.
We will send confirmation letter to you once your application has been approved by organizer. If you have any question regarding to this event , you may contact through jeffrey.feng@ubm.com
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1.
Full Name
*
2.
City & Country
*
3.
Email
*
4.
Cell Phone Number
*
5.
Occupation
Dentist
Dealer
Manufacturer
Other (please specify)
*
6.
Organization Name
*
7.
Product catagories you may be interested in【Multiple】
Dental Equipment
Furnishings
Orthodontic
Invisible Orthodontic
Oral Implantology
Materials for Dental Laboratory and Prosthodontics
Dental Imaging
Root Canal Treatment Materials
Instruments and Tools
Control and Oral Health
CADCAM
Other (Please specify)
*
8.
Purchasing Budget (USD)
0-5,000
5,001-20,000
20,001-50,000
50,001-100,000
100,000 and above
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9.
Are you willing to upgrade to VIP or VIP PLUS? For more info please click: http://www.dentech.com.cn/en-us/International-Visitor-Program
Yes
No
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10.
From which channel did you know about this program?
Infodent
Dental Access
Dental Associations (indentify the country)
None of Above
*
11.
Which of the following route do you prefer the most for Orientation Tour?
Dental Equipment
Materials for the Dental Laboratory & Prosthodontics
Oral Health Products