E X HIBITOR PROSPEC TUS
R ura l HI V Re s e a rc h an d Trai n i n g Co n feren ce OCTOBER 23-24, 2015 Coastal Georgia Center, Savannah, GA
PARTNERSHIPS
KEYNOTE PRESENTATION
Southeast AIDS Training and Education Center (SEATEC) at Emory University 2015 BRISTOL-MYERS SQUIBB KEYNOTE SPEAKER
Linda H. Scruggs, MHS Director of The Ribbon Consulting Group (RCG), Washington, DC
Georgia Department of Public Health Office of Infectious Disease and Immunization Program SPONSORED BY The College of Education Georgia Southern University Statesboro, GA
CONTINUING EDUCATION
NE T WORK
with over 100+ health care providers including physicians, nurse pracitioners, physician assistants, case managers, public health workers, psychologists, counselors, social workers, and family therapists.
E X HIBITO R O PP O R TUNITIE S $150 for Economy Exhibitor Package
One 6-foot table, chair, one continental breakfast and break and conference materials.
$250 for regular Exhibitor Package Two 6 foot tables, chairs, two continental breakfasts and breaks and conference materials.
$500 for CONTRIBUTOR Package Two 6 foot tables, chairs, continental breakfasts and break and listing as a contributor on the conference website, signage at the conference, one additional table at no charge and you may send an additional representative at no charge.
$100 for each additional table
SP O NS O R SHIP O PP O R TUNITIE S $1000 for SPONSOR Package Two 6 foot tables, chairs, continental breakfasts and break and listing as a sponsor in all promotional materials, the conference website, and signage at the conference. One additional table at no charge, quarter page full color ad in the conference program, and you may send an additional representative at no charge. * Quarter Page Full Color Ad, Ad size: 4.25�w x 5.50�h, PDF format, Deadline: September 15, 2015
Coastal Georgia Center Floor Plans
Exhibit Space
CGC main lower
For more information contact Mary Jernigan 912.478.2584 mjernigan@georgiasouthern.edu
DIVISION OF CONTINUING EDUCATION Georgia Southern University
EXHIBITOR REGISTRATION REQUEST
Mail, fax, email or phone form to:
PROGRAM # 15AAAED4676A
Continuing Education Registrations P.O. Box 8124 Statesboro, GA 30460-8124 Phone: 855-478-5551 (toll-free) Fax: 912-478-0847 email: CE-Registrations@georgiasouthern.edu
Rural HIV Research and Training Conference October 23-24, 2015 Coastal Georgia Center, Savannah, GA
1. EXHIBITOR Registrant Information Name: Last First MI Employer/Organization: Title: Address o Home
o Work:
City: State: ZIP: Cell Phone #: Home Phone #: FAX #: email (Required for e-mail receipt): Indicate items are to be displayed: Representative Name (Person attending conference):
EXHIBITORS FEES - Exhibitor space is NOT reserved until payment is received. Exhibitor fees are non-refundable.
AMOUNT
$250
Regular Exhibitor Package (includes two 6 foot tables, chairs, two continental breakfasts and breaks and conference materials)
$160
Economy Exhibitor Package (includes one 6-foot table, chair, one continental breakfast and break and conference materials)
$500
CONTRIBUTOR Package (includes two 6 foot tables, chairs, continental breakfasts and break and listing as a contributor on the conference website, signage at the conference, one additional table at no charge and you may send an additional representative at no charge.)
$1000 SPONSOR Package (includes two 6 foot tables, chairs, continental breakfasts and break and listing as a sponsor in all promotional materials and on website, signage at the conference, one additional table at no charge, quarter page full color ad in the conference program, you may send an additional representative at no charge) * Quarter Page Full Color Ad, Ad size: 4.25” w x 5.50” h, PDF format, Deadline: AUGUST 11, 2015
TOTAL
3. Method of Payment
o Personal check (Payable to Georgia Southern University) (include attendee’s name, course number, and course date on all checks.) o Organization check (Payable to Georgia Southern University) o Credit Card o personal o VISA
o corporate
o MASTERCARD
o AMEX
o DISCOVER
Account Number: Expiration Date: Security code: Cardholder’s Name: (please print) Signature:
SPECIAL ACCOMMODATIONS: For special assistance, please request accommodation needs at least 14 working days in advance of the program. PAYMENT POLICIES: Exhibit Space is not officially reserved until payment is received. Cancellation of your exhibit reservation will result in a $50 service charge being withheld from your refund. There are NO refunds after 8/31/2015.