2025 ACS Surgeons and Engineers Exhibit Agreement

2025 ACS Surgeons and Engineers: A Dialogue on Surgical Simulation

Exhibit Agreement

March 22 - 23, 2025
Please complete the form below and submit.
Company Name*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company's Website*
Contact Name*

First NameLast Name
Contact Email*
example@example.com
Contact Phone Number*
Please enter a valid phone number.
Product Description*
Special Needs
Exhibit Fees
One 6-foot table

$2,450 (Two complimentary badges are included)
Two 6-foot tables

$4,900 (Four complimentary badges are included)
Additional Badge

$400 each
How many additional badges
Please check if your company will be contributing an educational grant

Educational Grant
List the educational grant amount designated
Total Due *
Payment
Payment Type

Check
Please mail checks to American College of Surgeons, 633 N St. Clair Street, Chicago, Illinois 60611, Attn: Dana McClure, Exhibit Coordinator
Credit Card

VisaMastercardAmerican Express
Dana McClure, ACS Exhibit Coordinator, will contact you regarding credit card payments.
Rep Badge Names
Please include the name, title, and contact information for each attendee.
Rep Name

First NameLast Name
Rep Email
example@example.com
Rep Name

First NameLast Name
Rep Email
example@example.com
Rep Name

First NameLast Name
Rep Email
example@example.com
Rep Name

First NameLast Name
Rep Email
example@example.com
This exhibit agreement is due by February 14, 2025.
By submitting this application for exhibit space, you agree that—as an Exhibitor—you are bound to follow the Exhibit Rules and Regulations.*

Yes, I agree to the Exhibit Rules and Regulations
Should be Empty:

Exhibit Fees

Payment

Rep Badge Names