2026 Dermatology EXHIBITOR REGISTRATION FORM

We're excited to meet again at the Big Cedar Lodge in Branson, MO! The ADS Annual Meeting will take place on April 24-25, 2026.

Platinum ($5,500): Exhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Web banner on ADS website homepage - Special event sponsorship and recognition (choice of meal) - Two tickets for Friday Evening dinner

Gold ($4,500): Exhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Special event sponsorship and recognition (choice of meal) - One ticket for Friday Evening dinner

Silver ($3,500): Exhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Special event sponsorship and recognition

Tabletop ($1,500): Exhibit table in standard location.

Please select which level you are interested in:*

PlatinumGoldSilverTabletop

Company Name*

Company Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Coordinator's Name*

First NameLast Name

Coordinator Email Address*

Coordinator's Phone Number*

Please enter a valid phone number.

Representative's Name*

First NameLast Name

Representative's Email Address

example@example.com

Representative's Phone Number

Please enter a valid phone number.

Will this representative be attending Friday evening's dinner?*

YesNo

Will you have additional representatives attending?*

YesNo

How many additional representatives will be attending?

Additional Representative Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Will this representative be attending Friday evening's dinner?

YesNo

Additional Representative Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Will this representative be attending Friday evening's dinner?

YesNo

Additional Representative Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Will this representative be attending Friday evening's dinner?

YesNo

Additional Representative Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Will this representative be attending Friday evening's dinner?

YesNo

Agreement to Conditions: Exhibitor agrees to abide by the following: (1) No competing function will be allowed during this meeting; (2) the sole control of the exhibit center rests with ADS; and (3) ADS will not be responsible for any injury to any exhibitor or loss of property by fire, theft, damage, or other causes. Refund Policy: To cancel exhibit space, a written notification to ADS office must be received no later than March 21, 2026. No refunds will be issued after that date.

Paying by check, or by card?*

CheckCard

Select Contributor Level

Please make all checks payable to: Arkansas Dermatological Society

PO Box 55088

Little Rock, AR 72215

Additional Tickets Needed

Tickets Needed

p

g

s/t

Total

Contributor Level

PlatinumExhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Web banner on ADS website homepage - Special event sponsorship and recognition (choice of meal) - Two tickets for Friday Evening dinner

$5,500.00 Quantity

GoldExhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Special event sponsorship and recognition (choice of meal) - One ticket for Friday Evening dinner

$4,500.00 Quantity

SilverExhibit table in a prime location - Web banner on attendee registration page - Digital placement on monitors throughout conference - Verbal recognition throughout conference - Special event sponsorship and recognition

$3,500.00 Quantity

Tabletop ContributorExhibit table in a standard location.

$1,500.00 Quantity

Dinner TicketTickets for Friday Evening's dinner with attendees, fellow exhibitors, and staff. **IMPORTANT INFORMATION** The amount of tickets needed has been calculated for you. If additional tickets are required, a box will be shown below that contains the number of additional tickets needed.

$50.00 Quantity

Total

$0.00

Additional Tickets Needed

Tickets Needed

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

EXHIBITOR REGISTRATION FORM

Contributor Levels