OrthoDome® Application
Presentations will be assigned on a first-come, first-served basis.
Company Name
*
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
What sponsorship package do you want?
*
Premier Sponsor - Includes Six Videos for $40,000 (Limited to Two Sponsors)
Supporting Sponsor - Includes Four Videos for $28,000
Participating Sponsor - Includes One Video for $8,000
Presentation Information (Info Can Be Updated at a Later Time)
*
If the primary specialty is not available, do you have a secondary specialty for your video?
*
Yes
No
Secondary Specialty
Please Select
Adult Reconstruction Hip
Adult Reconstruction Knee
Foot and Ankle
Hand and Wrist
Pediatrics
Robotics
Shoulder and Elbow
Spine
Sports Medicine
Trauma
Brief Description of Surgical Technique or Device Featured in Video
*
This information will be shared with the moderators to determine if the video will be accepted.
Presenter Information
Please note:
AAOS is committed to fostering a broad range of perspectives and experiences within the orthopaedic community. We encourage companies to consider inviting speakers who are traditionally underrepresented in the field.
Would you like to have your video archived on the OVT website for an additional $800?
Yes
No
Comments
I am an authorized representative of the company named above and with the full power and authority to sign and deliver this application. The company listed above agrees to comply with all of AAOS policies, rules, and regulations contained in the
OrthoDome Brochure
,
Exhibit Prospectus
and all policies, rules and regulations adopted after publication of each, which we accept as part of this agreement.
Electronic Signature
*
Title
*
Date
*
Submit
Should be Empty: