2010 Annual Meeting
Exhibitor Registration
Exhibitor Registration
Company Name:
Contact Person:
Address:
City:
State:
Zip:
Phone:
Fax:
Mobile:
Admin Email (req):
Names for Exhibit Badges:
YES, I plan to exhibit at the FSO/HNS- FSFPRS Annual Meeting, November 6-8, 2009 at the Disney's Grand Floridian Resort & Spa in Orlando, Florida. We wish to participate this year at the following support level:
Platinum Patron (up to 4 reps)
$3500
PATRON LEVEL BENEFITS
Gold Patron (up to 3 reps)
$2500
Silver Patron (up to 2 reps)
$1500
No, I cannot display or attend the meeting
, but would like my company name to appear in the program as a supporter. Enclosed is my check for $200 for that support.
We also wish to host/help host the:
Continental Breakfast:
Saturday
Sunday
Coffee Break:
Friday
Saturday
Sunday
Cocktail Reception:
Friday
Other:
We will add the following amount onto our check for that sponsorship: $
OR
We will pay the hotel directly for hosting a breakfast, coffee or other event with a credit card.
Activities
I plan to attend the:
Friday, November 6, 6 - 7:30 pm
Cocktail reception in the Exhibitor Hall
# attending
A block of rooms has been reserved at Disney's Grand Floridian Resort & Spa at $255 per night, single or double occupancy. Call 407-824-1383 and book under the Florida Society of Otolaryngology or FSO room block. The room block is released on October 6.
.
When you submit this form you will be taken to a payment page to complete this registration.
For security purposes, please type the letters/numbers that you see in the image into the box below.
Florida Society of Otolaryngology - Head & Neck Surgery
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