2025 ACS AEI Surgical Simulation Summit Exhibit Agreement

2025 ACS Surgical Simulation Summit

Exhibit Agreement

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*

Company Logo**

Contact Name*

First NameLast Name

Contact Email*

example@example.com

Contact Phone Number*

Please enter a valid phone number.

Product Description*

Special Needs

Supporter - 6-foot table

$3,000 (Two complimentary badges are included)

Partner - 6-foot table

$5,000 (Three complimentary badges are included)

Leader - Two 6-foot tables

$7,000 (Four complimentary badges are included)

Champion - Two 6-foot tables

$10,000 (Five complimentary badges are included)

Additional Badge

$400 each

How many additional badges

Please check if your company would like to do any additional marketing/advertising opportunities

Networking Reception Co-Support - $5,000 (2 slots available)AM or PM Break Support - $3,000 (4 available)ACS-AEI Fellows Welcome Reception Support - $2,500 (1 available)

If you would like more information regarding the additional marketing advertising opportunities. Please contact Dana McClure, Exhibit Coordinator at dmcclure@facs.org.

Please check if your company will be contributing an educational grant

Educational Grant

List the educational grant amount designated

Total Due *

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.

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 1, 2024.

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

Exhibit Fees

Payment

Rep Badge Names