Sponsorship Request Form

A Goetze Dental Sales Representative must complete the Sponsorship Request Form.

The request form must be submitted with all paperwork to be considered.

Ideally, requests should be submitted at least 90 days prior to the deadline date. You will receive an email within 30 days letting you know if your request will be fulfilled.

Incomplete submissions will not be considered.

Goetze Dental evaluates sponsorship requests for the following:

charitable organizations or events that benefit children AND dentistry
sponsorship of study clubs or dental society continuing education courses our clients are involved with
dental student vendor fairs

Goetze Dental has a set sponsorship budget each year. Funds are distributed on a first come, first served basis and are reserved for current Goetze Dental clients.

If promotional materials will be needed, please email marketing@goetzedental.com with what you would like and by when. Please remember, promotional items usually take four to six weeks from concept to delivery. We usually have Goetze Dental pens and box cutters available.

Sponsorship Request Form

Sales Representative's Name*
Sales Representative's Email*
Type of Event
Please specify if this sponsorship request is for a student event, market specific trade show, CE event sponsorship, general event sponsorship or provide detail on the requet here
Is this a charitable or marketing event?*
Event Details
Event Name*
Event Location
Event Date*
MM slash DD slash YYYY
Event Website
Sponsorship Payment Details
Sponsorship Amount*
Date Sponsorship is Due*
MM slash DD slash YYYY
Check Payable To*
Please list the NAME of the charity or organization to whom the check should be made out to and the ADDRESS of where the check should be mailed.
Address of where the check should be sent*
About This Sponsorship
Description of Sponsorship Opportunity*
Please include a description of the sponsorship opportunity. Be sure to explain why Goetze Dental should support the event. Also include information on how Goetze Dental supporting the event benefits or a client or potential clients.
Who/what does this sponsorship benefit?*
(Sponsorship Recepient or Organization)
Has Goetze sponsored this event in the past?
If so, for how many years?
Names & GAIN level status of Goetze Dental Clients Attending*
Name GAIN Level Status
Number of Dentists Attending the Event*
File Upload
Please scan and upload relevant event marketing or informational materials or fax to 816-459-7064.
Drop files here or

Max. file size: 300 MB.
Marketing Materials
Please list they types and quantities of any marketing materials or giveaways you would like for this event. We usually stock Goetze Dental pens, box cutters and bags. All other items must be requested, estimated, budgeted for and ordered and can take up to six weeks for delivery.
Notes
Please share any additional information about this request here.