2021 Virtual Spring Meeting Supporter Information

Please complete and submit the form below, and email Jill any necessary items requested as soon as possible.*

Company Name

Please do NOT use apostrophe in Company Name.

Company contact name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary representative's name & cell phone

Are you offering a door prize?

PLEASE NOTE: It will be the responsibility of the Vendor to mail the door prize directly to the winner. Gift cards and items that can be easily mailed are suggested.

Yes

If yes, please list item here

Email Address

*Virtual Exhibit Hall: Hyperlink to relevant information on your website

Please supply a hyperlink to a page of your website for attendees to visit in our "Virtual Exhibit Hall."

*Virtual Exhibit Hall: Multiple choice question (see example below) about your product/service

Please provide a multiple choice question about your organization/company (one right answer & three wrong answers) -- the answer to which can be found at your website hyperlink -- for our Virtual Exhibit Hall questionnaire attendees will receive. EXAMPLE: What year did USA Children’s & Women’s Hospital complete its expansion, adding the new Strada Patient Care Center? A. 2003 B. 2013 C. 2017 D. 2019

*Gold Level Supporters ONLY: Please send your logo and, if commercial entity, your banner ad, for the Virtual Exhibit Hall by April 12, 2021 to Jill Powell.

2021 Virtual Spring Meeting Supporter Information

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