AAPM EXHIBIT SPACE
APPLICATION AND CONTRACT
Return by MARCH 2nd
for first consideration in space assignment
Booth assignment will be mailed week of March 28th
Email: rachel@aapm.org • Fax: 571-298-1301
EXHIBITOR / ORGANIZATION INFORMATION
Company:__________________________________________________________________________________________________ Date:______________________________________
(To be displayed in all printed materials)
If newly formed company, please list previous company name:__________________________________________________________________________________________
Exhibitor Contact Name (please print):__________________________________________________________________________________________________________________
Mailing Address:________________________________________________________________________________________ o Check if address change from previous year
City:______________________________________State:____________ Zip/Postal Code:______________________________ Country:______________________________________
E-mail (required):________________________________________________________ Tel:__________________________________ Fax:______________________________________
Marketing Contact Name:________________________________________________________________________ E-mail (required):______________________________________
SPACE
SELECTIONS
Invoice Contact Name (if different from Exhibitor Contact): __________________________________________________ E-mail:______________________________________
Booth Numbers (s)
Booth Size
Second Level Size
(For Island Booths Only)
# Corners Requested
(For Inline Booths Only)
Total Amount
1st ______________________
__________X__________
__________X__________
_____________________
$____________________
2nd _____________________
__________X__________
__________X__________
_____________________
$____________________
3rd ______________________
__________X__________
__________X__________
_____________________
$____________________
ASSOCIATE/COMPETITOR PROXIMITY
List any Exhibitors you wish to be near:
List any Exhibitors you do not wish to be near:
1.__________________________________________________________________________ 1.__________________________________________________________________________
2.__________________________________________________________________________ 2.__________________________________________________________________________
3.__________________________________________________________________________ 3.__________________________________________________________________________
SPACE ASSIGNMENT PRIORITY
Rank (1-4) beginning with most important criteria: ______Floor Location
______Associate Proximity
______Competitor Proximity
______Corner Space
PRODUCT CATEGORY (IMPORTANT – PLEASE CHECK THE APPROPRIATE BOXES)
Product Focus:
o Biotechnology
o Medical Imaging
o Radiation Oncology
o Tissue Engineering
o Information Technology
o Pharmaceuticals
o Radiosurgery
Product Line:
o Aides for Disabled
o Detectors/Dosimetry
o General Medical Physics
o Implantable Medical Products
o Laser & Optics Manufacturers
o Pharmaceutical Manufacturing
o Radiosurgery
o Simulators
o Treatment Planning
o Xray/Radiographic
o
o
o
o
o
o
o
o
o
o Laser & Optics
o Professional Staffing
Service Provider
Biotechnology Manufactures
o
Dialysis Equipment
o
Government Agencies
o
Implants and Artifical Organs
o
Nuclear Medicine
o
Professional Society
o
Robotics and Computer Automation o
Technology Management
o
Treatment Units
o
Brachytherapy
Electromedical Equipment
Home Healthcare
Info Systems Management
Organ Motion Management
Quality Assurance
Shielding/Construction
Telecommunications
Ultrasound
o Medical Equipment
o Publishing
o Other __________________
o
o
o
o
o
o
o
o
o
CT/MRI
Electronics, Semiconductors, Subassm
Imaging Film Instructional Laboratory Equipment
Patient Handling/Positioning
Radiation Therapy Simulation & Statistical Analy Software
Test and Measurement Equipment
Universities
Section 6: Exhibitor Agreement
I have read, understand and agree to adhere to the rules and regulations as stated in the 2016 AAPM Exhibitors Prospectus. The undersigned is empowered to enter
into contracts on behalf of the exhibiting company.
Completed by/Signature:___________________________________________________ Title:____________________________________ Date:_____________________________
NOTE: Upon receipt of Exhibit Space Application and Contract, Exhibitor will be invoiced for total amount of booth size requested. In order to be considered
for first round space assignment, full payment MUST BE submitted by MARCH 24th (per instructions provided on the invoice.)
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