2010 AMSSM Annual Meeting Exhibitor Contract

2010 AMSSM ANNUAL MEETING EXHIBITOR APPLICATION AND CONTRACT

You are hereby authorized to reserve space for one use in the exhibit hall at the AMSSM 19th Annual Meeting. This application is made with understanding that the applicant agrees to abide by all regulations outlined in the exhibit prospectus which becomes part of the accepted contract along with the other rules and directives which may be used by the sponsoring organizations in connection with these scientific sessions.

Please type your company name and address as you wish it to appear in the Course Syllabus:

Telephone Number:

Fax Number:

Preferred Email Address:

Company Website Address:

Name of Contact Person (for all correspondence):

Contact Persons Telephone Number

Alternate Email Address (different from address provided above):

Digital Signature (Your digital signature notes that you are authorized to reserve space at the Advanced Team Physician Course, you have agreed to pay for your booth space with this application and that you have read the rules and regulations):

AMSSM strives to offer exhibitors the most advantageous location for conduct of business. Please list exhibitors we should avoid placing adjacent or opposite your display:

As an added benefit, we will list your company's contact information as well as a brief description of products or services in the AMSSM 19th Annual Meeting Course Syllabus.

Please provide, in 40 words or less a description of your products or services. Please explain how your product or service is relevant to the professional needs of the AMSSM Annual Meeting attendees.

Rental Rates: A standard booth is $4,000 USD - Booth Size is 10' Wide x 10' Deep
Payment: Deposit due is $2,000 USD per booth. Final payment is due by March 12, 2010.

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Name as it appears on credit card:

Credit Card Number

CVV (on back of card)

Expiration Date:

Verification Code (This step helps prevent unfair use of automated programs)
Enter verification code as shown on the right: