T-Shirt Promotion Registration

Please fill out the form below to register your practice to receive t-shirts once 10 cases have been sent to Maverick Dental Lab.

Send 10 cases from 10/1/23-12/31/23 to redeem promotion.

If 10 cases are received, an email will be sent to your practice on 1/5/24 to collect t-shirt size requests.

*One t-shirt per team member. Limit 10 t-shirts per practice.

    Practice Name:

    Street Address (Where we will ship t-shirts to):

    City:

    State:

    Zip Code:

    Email (How we will contact you for t-shirt sizes):

    Phone Number: