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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 NameRRvalidation.gif>> Required
*Street Address1 (Cannot be a PO Box)RRvalidation.gif>> Required
Street Address 2 (Cannot be a PO Box)
*CityRRvalidation.gif>> Required
*StateRRvalidation.gif>> Required
*Zip CodeRRvalidation.gif>> Required
*Branch of ServiceRRvalidation.gif>> Required
*Installation / Unit NameRRvalidation.gif>> Required
Room Name
*Location Contact First NameRRvalidation.gif>> Required
*Location Contact Last NameRRvalidation.gif>> Required
*Location Contact Phone NumberRRvalidation.gif>> Invalid (XXX-XXX-XXXX)
Location Contact Phone Extension
*Location Contact Email AddressRRvalidation.gif>> Invalid Email Address
Location Alternate Contact Name
Location Alternate Contact Email
Location Alternate Contact Phone
*Number of Attendees Expected to AttendRRvalidation.gif>> Required

Event Information


*Event DateRRvalidation.gif>> Required
*Event Start TimeRRvalidation.gif>> Required
*Event End TimeRRvalidation.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 CityRRvalidation.gif>> Required
*Shipping StateRRvalidation.gif>> Required
*Shipping Zip CodeRRvalidation.gif>> Required
*Shipping Contact First NameRRvalidation.gif>> Required
*Shipping Contact Last NameRRvalidation.gif>> Required
*Shipping Contact Phone NumberRRvalidation.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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