SPONSORSHIP RESERVATION FORM DEADLINE DATE: May 13th (to include ad in Pocket Program) Return form to Rachel Smiroldo at rachel@aapm.org or fax 571-298-1301 Company Name:_______________________________________________________________________________________________ Contact:_____________________________________________________________ Title:______________________________________ E-mail:_____________________________________________________________Phone:______________________________________ Instructions: • Complete this form and return by May 13th to be included in the Pocket Program • Sponsors will be contacted with confirmation • Sponsors will be invoiced o _ATTENDEE TOTE BAG **Must Be Submitted by May 5th** Starting At $15,000/ Exclusive Sponsorship o MEETING APPLICATION ON SMARTPHONE o Splash Screen / Exclusive Sponsorship - $10,000 o Enhanced Listing / Unlimited Sponsorship - $1,000 o Featured Exhibitor / Unlimited Sponsorship - $300 o WIDE EMOTION - MEDIA WALL (pricing varies) o INTERNET and MEETING EVALUATION CENTERS - $ 3,000 per sponsor o LUNCH BUNDLE VOUCHERS - $2,500 per sponsor /per day o Monday o Tuesday o NEW MEMBER SYMPOSIUM REFRESHMENT BREAK - $1,500 per sponsor EXHIBIT HALL MORNING AND AFTERNOON BREAKS - $1,000 per break (7 sponsorships available) Sunday o 12:30 pm o 3:00 pm Monday o 9:30 am o 3:45 pm Tuesday o 9:30 am o 3:45 pm Wednesday o9:30 am o o ELECTRONIC HOTEL KEY CARDS / Exclusive Sponsorship - $1,000 plus project costs o MOBILE DEVICE CHARGING STATION o Welcome Lounge Buy Out / Exclusive Sponsorship - $1,000 o Short Video Clip - $500 o Image Displayed - $200 Clear Form Print Form Submit Form