COSM 2022 Exhibit Space Application

COSM 2022 Exhibit Space Application

April 27- May 1, 2022 - Hyatt Regency Dallas - Dallas, Texas
ALL COSM 2022 EXHIBIT SPACE HAS BEEN SOLD.

Please click here to be re-directed to the COSM 2022 exhibit space waitlist. You will be contacted if exhibit space becomes available.

DO NOT COMPLETE THIS ONLINE PPLICATION.
Company Information
Company Name *
Contact Full Name *
Contact Phone Number *
Please enter a valid phone number.
Contact Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State

Zip Code
Website
Payment Information
Exhibit space confirmation, registration and other details will be sent to the contact person listed above.

Exhibit Deposit: A 50% deposit of $1,650 is required with online application. Exhibit Space Applications will not be processed without deposit.

Full payment is due on Monday, March 7, 2022.

Cancellation/Refunds: Written notification of a reduction or cancellation of exhibit space must be received by COSM on or before March 7, 2022 and will result in a charge equal to 50 percent of the total cost of the space. Space not claimed or occupied on-site after 5:00 pm Wednesday, April 27, for which no special arrangements have been made with COSM, may be resold or reassigned by COSM without obligation to refund exhibit fees or reassign the exhibitor. There will be no refunds for cancellation of space issued after March 7, 2022.
Credit Card Payment

If paying via credit card, make your selection below, provide credit card information, sign and click Submit. An email confirmation will be sent. If you have any questions, contact Judy Hambrick at jhambrick@facs.org or 312,202.5034
Credit Card - 50% Deposit

If you are providing 50% deposit with your application, enter COSM2022 in Coupon Field and click Apply. Your credit card will be charged 50% of the total costs. If no coupon code is entered, your credit card will be processed for full amount.

My Products

Exhibit Opportunities

Basic (Single 10x10 Booth)

$ 3,300.00

Enter coupon

Total

$ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Check Payment

If paying via check, make your selection below, sign and click Submit. An email confirmation will be sent to confirm receipt of application. Exhibit Space Confirmation will be sent once payment has been received. If you have any questions, contact Judy Hambrick at jhambrick@facs.org or 312.202.5034
Booth Selection
Multiple selections can be selected by using CTL and clicking on selection
Check Payment: Make check(s) payable to: COSM 2022

Send payment to:

COSM 2022
c/o American College of Surgeons (attn: Judy Hambrick)
633 N. St. Clair St, Suite 2200
Chicago, IL 60611
Booth Selection

The floor plan should be carefully reviewed. Indicate four (4) exhibit booth choices in order of preference. If exhibit choices are not available when exhibit space is assigned, the exhibitor agrees to accept the space assigned.
Booth Choice #1 *
Booth Choice #2
Booth Choice #3
Booth Choice #4
Would you prefer a corner booth? Corners are $200 each *

Yes No
Indicate below companies you DO NOT wish to be near. If none, enter N/A
Authorized Signature
As an authorized representative of the company named above I have read and understand the rules and regulations outlined in the 2022 COSM Exhibit Prospectus. I understand and agree to accept and abide by those rules and regulations. The acceptance, by COSM, of our application and deposit on rental charges constitute a contract.
Authorized Signature *

Clear
Should be Empty:

COSM 2022 Exhibit Space Application

Company Information

Payment Information

Credit Card Payment

Credit Card - 50% Deposit

Check Payment

Booth Selection

Authorized Signature