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Practice Name*  
Contact Name*  
Address*  
Postcode*  
Telephone  
Email Address*  
You will receive an automated acknowledgement via email. The information you have provided us will be used to inform you of new products and services available from GSK. We would also like to inform you of future publications and events. Please tick the relevant box(es) below if you do not wish to receive any such information in the formats specified:-
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A maximum of 6 tickets are available for each practice. Please enter below names of all attendees including the person named above if applicable.
Attendee 1 Name  
Occupation*  
GDC No**  
Attendee 2 Name  
Occupation*  
GDC No**  
Attendee 3 Name  
Occupation*  
GDC No**  
Venue*  
* mandatory ** mandatory where applicable

Please apply for tickets using this web form.
You will receive confirmation of successful
application by post.

If you would like a visit from your Dental Territory Manager or receive an application form by post please call
020 8047 2700. For queries or cancellations please contact Jemma Barden on 01663 750450 or 07970 675336.

Admission is free to all members of your Dental Team.

We kindly request that you only apply for tickets for those people you are certain will make every effort to attend. In previous years other applicants have missed out when spaces were actually available due to 'no-shows'.

Registration will be at 6.00pm with the programme starting at 6.30pm and finishing at approximately 10.00pm.

A light buffet will be provided.

We look forward to seeing you at your nearest event.


Places will be allocated on a first come,
first served basis.

GlaxoSmithKline Consumer Healthcare
(GSK) does not charge for this event, but
to avoid wasted costs we would
appreciate cancellations being
notified at least 24 hours before
the event. Where cancellations
are received after that time, it
may be taken into account
in allocating tickets for
future events.

2008 VENUES
 
Tuesday May 6th 2008
The Marriott Hotel, City Centre - Bristol
Wednesday May 7th 2008
The Holiday Inn - Plymouth
Thursday May 8th 2008
De Vere Whites Hotel
Reebok Stadium - Bolton
Monday May 12th 2008
The Novotel - Southampton
Tuesday May 13th 2008
New Venue  IBIS Hotel, Earls Court - London
Wednesday May 14th 2008
The Hilton Hotel - Watford
Thursday May 15th 2008
Motorcycle Museum - Solihull
Monday May 19th 2008
The Hilton Hotel - Belfast
Tuesday May 20th 2008
Airth Castle - Falkirk
Wednesday May 21st 2008
The Marriott Hotel, Metro Centre - Newcastle
Thursday May 22nd 2008
Elland Road Football Club - Leeds