2023 Biologic Association Summit Exhibitor Registration and Contract

2023 Biologic Association Summit Exhibitor Registration and Contract

If you have any questions, please contact Christine Nogal christinen@aana.org
Exhibitor Contact Information

NOTE: This section does not constitute a badge.

RATE BEFORE 03/01/2022: $3,000 RATE AFTER 03/01/2022: $3,250
Exhibitor Rate
Organization/Company*
Company website:*
Contact Name (person handling logistics/operations):*

Prefix First Name Middle Name Last Name Suffix
Contact Title:
Email*
example@example.com
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Contact Office Phone:

Area Code Phone Number
Contact Cell Phone:

Area Code Phone Number
Promotion/Sponsorship Contact Name (if different):

Prefix First Name Middle Name Last Name Suffix
Promotion/Sponsorship Contact Title:
Promotion/Sponsorship Contact Email:
example@example.com
Promotion/Sponsorship Contact Office Phone:

Area Code Phone Number
Promotion/Sponsorship Contact Cell Phone:

Area Code Phone Number

Exhibitor(s) we DO NOT want in proximity (if possible):*
(AANA will do its best to accommodate requests; however, no guarantee as to this aspect of placement will be made.)
FDA COMPLIANCE - Will your exhibit include any non-FDA approved drugs or devices?*

YesNo
Product Information - please give a 25 word description of your exhibit that will be included in the Final Program:*
I am interested in sponsoring one of the two Lunch and Learn opportunities:

YesNot Interested

REPRESENTATIVES ALLOTMENT FOR BADGES - 2 (Page 2 of 4)

You can add up to 2 representatives for the same cost.

ADDITIONAL REPRESENTATIVES - $150.00 EACH (Page 3 of 4)

If you would like to add an additional representative to the Exhibitor, it will cost $150 each.

ADDITIONAL REPRESENTATIVE 1
Would you like a single additional representative for $150.00?
Organization/Company that should appear on the badge (Additional Representative 1)
Name (Additional Representative 1)

Prefix First Name Middle Name Last Name Suffix
Email (Additional Representative 1)
example@example.com
Address (Additional Representative 1)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

ADDITIONAL REPRESENTATIVE 2
Would you like a Second additional representative for $150.00?
Organization/Company that should appear on the badge (Additional Representative 2)
Name (Additional Representative 2)

Prefix First Name Middle Name Last Name Suffix
Email (Additional Representative 2)
example@example.com
Address (Additional Representative 2)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

ADDITIONAL REPRESENTATIVE 3
Would you like a Third additional representative for $150.00?
Organization/Company that should appear on the badge (Additional Representative 3)
Name (Additional Representative 3)

Prefix First Name Middle Name Last Name Suffix
Email (Additional Representative 3)
example@example.com
Address (Additional Representative 3)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

ADDITIONAL REPRESENTATIVE 4
Would you like a Fourth additional representative for $150.00?
Organization/Company that should appear on the badge (Additional Representative 4)
Name (Additional Representative 4)

Prefix First Name Middle Name Last Name Suffix
Email (Additional Representative 4)
example@example.com
Address (Additional Representative 4)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

ADDITIONAL REPRESENTATIVE 5
Would you like a Fifth additional representative for $150.00?
Organization/Company that should appear on the badge (Additional Representative 5)
Name (Additional Representative 5)

Prefix First Name Middle Name Last Name Suffix
Email (Additional Representative 5)
example@example.com
Address (Additional Representative 5)

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

My Products

USDDescription