2011 Exhibitor Registration
Organization and Contact Information
Name of organization (as it should appear in the conference program)
Street
City
State/province Please choose Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming -- Canadian provinces -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Ontario Prince Edward Island Quebec Saskatchewan
Zip
Name of organizational contact
Email address
Work phone
Cell phone
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Sponsorship Information
Sponsorship level Major ($25,000) Flagship ($10,000) Platinum ($5,000) Gold ($3,000) Silver ($2,000) Bronze ($1,500) Blue ($1,000) Green ($610)
To view details for each Sponsorship level, please review the Sponsorship package
Note: If you are logged in as a corporate member, you receive 10% off the sponsorship price. The discount is reflected in the Total below.
Exhibit Information
Will your Exhibit include a Large Table Top Display? (Exhibitor tables are 5' x 30') Yes No
Will your Exhibit include a Booth? Yes No
Would your organization like to post a job (or jobs) as part of the IMIA Job Connection display? Yes No
If Yes, please email your job position and description to IMIAConference@imiaweb.org by Sept. 15th. 2011.
Please provide the name of one representative manning Exhibit table for Conference Registration purposes, as you would like it to appear on name badge. The IMIA will register this person.
Name of person manning booth:
Email address of person manning booth:
Additional Conference Registrant(s) included in your Sponsorship Package Major (6 included), Flagship (4 included), Platinum (3 included), Gold, Silver, Bronze, Blue and Green (2 included) - IMIA will register those listed. Email addresses are required.
Individuals utilizing IMIA Memberships included in your Sponsorship Package Major and Flagship Sponsorship packages include a 1-year Corporate Membership which allows for 3 organizational representative members - the additional individual memberships below may be for members in addition to those 3. Major (7 Individual included), Flagship (5 individual included), Platinum (6 included), Gold (4 included), Silver (3 included), Bronze (2 included), Blue (1 included). Email addresses are required. These individuals must submit a membership application at http://www.imiaweb.org/members/application.asp.
Advertising Information
$100 for 1/4 (quarter) page b+w $150 for 1/2 (half) page b+w $300 for full page b+w $500 for insert in tote bags (you print and ship inserts to IMIA) $600 for insert in tote bags and full page in booklet (print and on line)
Ad Specs
Once you have submitted your Sponsorship registration, please email ads (high resolution JPEG format only) to IMIAConference@imiaweb.org. Deadline for Ad submissions is Aug. 12th, 2011.
Payment Information
Sponsors who register and pay by March 31st, 2011 will receive an additional 10% off the sponsorship amount! (Corporate members would receive a 20% discount total.)
Sponsorship payments must be paid in full by or before July 29th, 2011 in order to exhibit at the conference.
Please note: there is complimentary WiFi Internet Access
I will need the following (additional charges apply):
Advertising:
Total Amount: $
Please list any additional needs or special requests you may have.
An invoice will be generated upon submission of your online Sponsorship Registration form and will be emailed to the organizational contact, however you may feel free to pay prior to receiving the invoice.
Online payment is highly recommended to ensure timely payment and to guarantee your spot at the conference and/or placement of your ad in the Conference booklet. When you hit the Submit button, you will automatically be directed to the on-line payment page.
IMIA 800 Washington St. Box 271 Boston, MA 02111-1845
Once payment is received, Exhibitors will be notified by email and supplied a floor plan/exhibitor map to pick table preferences.
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