2024 Exhibitor Registration Form

Thank you for your interest in exhibiting with us. Please complete the following form and provide the information so that we may process your order. We look forward to seeing you at the Maine Chapter ACS conference March 22-24, 2024!


Contact Information

Company
Contact First Name
Contact Last Name
Title
Daytime Phone
Email

Exhibit Directory Listing Information (if different)

Company Name
Address
City State Zip
Daytime Phone Fax
Website
Please select your sponsor level
SILVER SPONSOR ($1,500.00)
Name listed in the MEACS Annual Conference Participant Materials
Verbal acknowledgement by the MEACS President during opening remarks
Logo on printed sign in Exhibit Hall with Silver Sponsors
Exhibitor Table at Annual Conference
GOLD SPONSOR ($2,000.00)
Full Page AD in the MEACS Annual Conference Participant Materials
Verbal acknowledgement by the MEACS President during Welcome reception and during opening remarks
Logo on printed sign in Exhibit Hall with Gold Sponsors
Logo on MEACS Website with a Link
Prime Exhibitor Table space at Annual Conference
Description of company and products/services (100 Words Max)
 

Directory Information for On-Site Representatives

Representative #1
Name
Title
Email
Cell Phone
Please Select Which Meals You Plan To Attend:
Welcome Reception
Saturday Breakfast
Saturday Lunch
Presidents Dinner
Sunday Breakfast
Representative #2
Name
Title
Email
Cell Phone
Please Select Which Meals You Plan To Attend:
Welcome Reception
Saturday Breakfast
Saturday Lunch
Presidents Dinner
Sunday Breakfast
Electricity needed? (Note: You must bring your own extension cords)

Agreement

The Maine Chapter, American College of Surgeons, hereinafter referred to as Maine Chapter, is hereby requested and authorized to reserve exhibit space for our use during the ME Chapter Annual Meeting. It is understood and agreed that all space will be assigned on a first-come, first-served basis and that Maine Chapter reserves the right to decline any application or disallow any exhibit which is not in keeping with the character of the meeting and to make reasonable shifts in location for the benefit of the exhibitor or deadlines and details. Exhibitors are bound by the exhibitor specifications and conditions on the Exhibitor Agreement (available online and sent with the email invitation). The MEACS agrees to provide booth space, furniture (one six-foot table and two chairs), and two complimentary registrations to all conference breaks and food functions. An attendee list will be provided at the conference.
I have read and agree to the terms and conditions of this contract and the Exhibitor Agreement
(please initial)

Total Amount Due

Total Amount Due will be Provided on Next Screen.

Tax ID # 20-4019098
(The MEACS W-9 Form can be requested by emailing nfederico@mainemed.com)
   - denotes required fields