Webinar Intake FormCompany Name(Required)Company Website(Required) Company Short Description(Required)Contact Name(Required) First Last Contact Email(Required) Contact Phone(Required)Upload Company Logo Below(Required) Drop files here or Select filesMax. file size: 12 GB, Max. files: 1.Sponsor's Facebook Example = https://www.facebook.com/MedMarkLLCSponsor's LinkedIn Example = https://www.linkedin.com/company/3665270/Sponsor's Instagram Example = https://instagram.com/medmarkmediaWebinar Title(Required)Webinar Description and Learning Objectives(Required)Continuing Education Credits Offered(Required) Yes No8-10 CE Questions & AnswersWebinar Images(Required) Drop files here or Select filesAccepted file types: jpg, jpeg, png, Max. file size: 12 GB.Please add 5-6 ImagesPublication Audiences Orthodontic Practice Endodontic Practice Implant Practice Dental Sleep PracticeType of Webinar(Required)FormalInterviewOtherSelect oneWebinar Day of WeekMondayTuesdayWednesdayThursdayFridaySaturdaySelect oneWebinar Day of Week Hours: Minutes AMPM AM/PMTime of Day: Best practice is to host webinar during the Lunch Hour or in Evening.Suggested Webinar Date MM slash DD slash YYYY Suggested Webinar Date: Best practice is to schedule on a Tuesday, Wednesday or Thursday.Suggested Dry Run Date (2 Weekw Prior to Webinar) MM slash DD slash YYYY 10 Topic QuestionsSpeakers Name(Required) First Last Speaker's Email(Required) Speaker's Phone Number(Required)Speaker's LinkedIn Speaker's Facebook Speaker's Instagram Speakers Hashtags (example #dentalsleep)Speaker's Bios(Required)SPEAKER BIO: MedMark Media is a peer to peer education vehicle for your products and services. Best practice would be to have a dentist speaking to other dentists in a way that explains the benefits of your services or products.Speakers Headshot Drop files here or Select filesAccepted file types: jpg, jpeg, png, Max. file size: 12 GB.CAPTCHA
