2020 Ancillary/Affiliate Meeting Space Listing Submission
This form is for organizations who have already contracted space in conjunction to ANESTHESIOLOGY® 2020, October 3 - 7 in Washington DC. Your function will be listed on the: Anesthesia-Related Meetings Wall at ANES2020 On the ANESTHESIOLOGY® website At our information desk On the ANESTHESIOLOGY® mobile app
CONTACT INFORMATION
(Fields Marked with * are required)
Ancillary /Affiliate Contact Person
*
Organization/Institution /Company Name
*
Address
*
City
*
State
*
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip
*
Phone
*
Fax
*
Email
*
MEETING/FUNCTION SPECIFICATIONS
Meeting /Function Name
*
Meeting Function - Description/Purpose
*
Meeting Start Date
*
-
Month
-
Day
Year
Date Picker Icon
Meeting Start Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Meeting End Date
*
-
Month
-
Day
Year
Date Picker Icon
Meeting End Time
*
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Expected Number of Attendees
*
Preferred Meeting Location
*
Capital Hilton
Embassy Suites DC
Hilton Garden Inn
Hyatt Place DC US Capitol
Renaissance DC
The Darcy
Westin Washington DC
Washington Marriott Marquis
* Please note: Washington Marriott Marquis has very limited space.
Second Location Option (if first is not available)
Capital Hilton
Embassy Suites DC
Hilton Garden Inn
Hyatt Place DC US Capitol
Renaissance DC
The Darcy
Westin Washington DC
Washington Marriott Marquis
If other, please list property here:
Meeting/Function Space Set
*
Conference
Hollow Square
U-Shape
Banquet Rounds
Classroom/Schoolroom
Theatre
Reception
MEETING/FUNCTION TYPE
Type of event:
Committee Meeting
Board Meeting
Alumni Reception
Reception/Dinner
Other
If other, please list type here:
Check here if this meeting/function is educational in nature
Check here if this meeting/function has an invited speaker to present
No
Other
Check here if marketing materials will be produced for this function/meeting. Please Note: ASA requires review of all marketing materials prior to production and distribution for the proposed event
Submit
Should be Empty: