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TRICARE Dental Program

To request a MetLife representative attend your event, please enter your information below. If you are requesting an event for more than one location or for multiple dates, please submit a separate request.

Please do not submit your request until all information is confirmed (i.e. location, date, time of event). Information listed as "TBD" should not be submitted. We are unable to process your request or schedule a resource to attend until the event information is final/confirmed.

Event Supplies (giveaways and print material) are shipped to arrive ~ 3-5 business days before the 1st day of the event. If a MetLife resource is scheduled to attend your event, please ensure supplies are available to them for distribution before the start of the event.

To ensure a resource is available to attend your event, please submit your requests with complete information no later than 10 days prior to the event date.
All reasonable attempts will be made to accommodate the request.

* Required Fields

Event Information


Customer Name
*Location Name RRvalidation.gif>> Required
*Street Address1 (Cannot be a PO Box) RRvalidation.gif>> Required
Street Address 2 (Cannot be a PO Box)
*City RRvalidation.gif>> Required
*State RRvalidation.gif>> Required
*Zip Code RRvalidation.gif>> Required
*Branch of Service RRvalidation.gif>> Required
*Installation / Unit Name RRvalidation.gif>> Required
Room Name
*Location Contact First Name RRvalidation.gif>> Required
*Location Contact Last Name RRvalidation.gif>> Required
*Location Contact Phone Number RRvalidation.gif>> Invalid (XXX-XXX-XXXX)
Location Contact Phone Extension
*Location Contact Email Address RRvalidation.gif>> Invalid Email Address
Location Alternate Contact Name
Location Alternate Contact Email
Location Alternate Contact Phone
*Number of Attendees Expected to Attend RRvalidation.gif>> Required

Event Information


*Event Date RRvalidation.gif>> Required
*Event Start Time RRvalidation.gif>> Required
*Event End Time RRvalidation.gif>> Required
Type of Event

Shipping Address


(Check if same as Location Address)

MetLife will ship materials to this event. You do not need to order them.


*Shipping Address (Cannot ship to PO box) RRvalidation.gif>> Required
Shipping Address 2 (Cannot ship to PO box)
*Shipping City RRvalidation.gif>> Required
*Shipping State RRvalidation.gif>> Required
*Shipping Zip Code RRvalidation.gif>> Required
*Shipping Contact First Name RRvalidation.gif>> Required
*Shipping Contact Last Name RRvalidation.gif>> Required
*Shipping Contact Phone Number RRvalidation.gif>> Invalid (XXX-XXX-XXXX)
Shipping Contact Phone Extension

Special Requests


Comments

Submission of this request does not guarantee representation at your event.

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