Colgate Professional CE Support

Requests for support from Colgate will be considered from organizations who are providing continuing education events for Dental Professionals. There are two support options available.

• A CE Sponsorship which can be used to help defray the costs of putting on a continuing education event
• OR
• A Colgate Professional Education Manager to present a scientific program (subject to availability, Organization to provide CE credit(s)). To learn more about the scientific programs available please click here.

Submission of a request does not guarantee that a sponsorship will be awarded or that a Professional Education Manager will be available. Our goal is to support as many Dental Professionals as possible across the United States and Canada.

Priority will be given to events that meet the following guidelines:

• Provide an exhibit table
• A Colgate Territory Manager is available to attend
• Minimum expected attendance of 50 practicing Dental Professionals

Please complete the application form below and allow 4-6 weeks for a response.

Type of Support Request
Please select one:	A CE Sponsorship which can be used to help defray the costs of putting on a continuing education event A Colgate Professional Education Manager to present a scientific program (subject to availability). To learn more about the scientific programs available please click here.
Organizer Information
Organization name
Organization Website:
Organization Social Media Platform:
Contact Person Name:
Contact Person Email:
Contact Person Mobile Phone:
Contact Person Address:
Contact Person Address 2:
Contact Person City:
Contact Person State/Province:	Select One Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Contact Person Postal Code:
Requested Sponsorship Amount:
Pay To Information:
Event Information
If you're hosting a virtual event, please enter the complete address where you're hosting the virtual event so the request is routed to the correct Colgate Professional Education Manager for approval.
Date of event:
Start Time and End Time:
Location Address:
Location Address 2:
Location City:
Location State/Province:	Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Location Postal Code:
Expected Attendance:
Event Topic:
Speaker(s) Name(s) if Known:
Speaker Affiliation:
Who is the intended audience? EX: Dentists? RDHs? DAs? Specialists?
Will a table for a Colgate Territory Manager be included/Size? Where will the table be located?
Please attach a PDF, Word or JPG document detailing the agenda including topics and speakers and times allotted for attendees to visit the Colgate table.