EXHIBITOR / VENDOR AGREEMENT – EXHIBIT SPACE TEMPLATE (If using this template, delete this line , as well as all other highlighted text and blank rows from the final agreement) Exhibitor/Vendor Agreement between (company name) (Exhibitor or Vendor) and the (full name of chapter) Chapter of the American Association of Critical-Care Nurses (Chapter) Event / Course Title: Class Format: (lecture, conference, etc.) Date: (Month/Day/Year) Location: (Name of facility / hotel) Exhibitor/Vendor Company Name: Address: City, State, Zip: Telephone: Contact Name: Payment: TERMS & CONDITIONS Full payment of exhibit space is due by (insert date at least one week prior to event). Make check payable to: (full chapter name) Chapter Send completed, signed agreement and payment to: (Name) (address) (city, st, zip) Please Reserve One table at $ each Two tables at $ each Other (please specify) (check one): Telecomm/Phone Line Service Electrical Service Exhibit Space Includes: Yes No Yes No Sorry, this service not available for this event Sorry, this service not available for this event Booth carpet Skirted 6-ft. table Two chairs Waste basket Products to Be Exhibited (list all): Participants: It is AACN’s philosophy not to exclude any AACN members from chapter TERMS & CONDITIONS events. If this presents a problem for any exhibitors / vendors, please immediately contact the AACN Chapter Department to help reach a resolution. Participant List: (select one) The Exhibitor/Vendor does not request a participant list. The Exhibitor/Vendor requests a participant list. Chapter will circulate a “Participant List” at the event for participants to enter their personal contact information. Each participant will have the option to “opt out” of the list that will be provided to the Exhibitor/Vendor by not completing their information. Cancellation: If written notice of cancellation is received by Chapter: More than 150 days before the event: 25% of the exhibit fee will be retained by AACN. 150 – 90 days before the event: 50% of the cost of the exhibit fee will be retained by AACN. Less than 90 days before the event: 100% of the cost of the exhibit space will be retained by AACN. If Chapter cancels the event, the Exhibitor/Vendor will be refunded 100% of monies paid within 5 business days. ACCEPTANCE x Signature (name), (title), (company name) x Phone # x Date x Signature (name), President (chapter name) Chapter-AACN x Phone # x Date x Signature (name), (title – Treasurer or Chairperson) (chapter name) Chapter-AACN x Phone # x Date Please Note: All Exhibitor/Vendor Agreements must be reviewed and approved by AACN’s national office before signing. Submit online at www.aacn.org/chapters > Forms > Chapter Contract Submission Form. ACCEPTANCE Please allow up to two weeks for contract review. All AACN chapter contracts must be signed by the chapter president, and chapter treasurer or appropriate chairperson. Please refer to the Chapter Contracts Policy on the website at www.aacn.org/chapters > Contracts. [This page intentionally left blank.] PARTICIPANT LIST IMPORTANT NOTE: This list is for the chapter and will be provided to the Exhibitor(s)/Vendor(s) unless you check the “Opt Out” box in front of your name. Opt Out First Name 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Last Name Phone # Email Organization PARTICIPANT LIST IMPORTANT NOTE: This list is for the chapter and will be provided to the Exhibitor(s)/Vendor(s) unless you check the “Opt Out” box in front of your name. Opt Out First Name 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 Last Name Phone # Email Organization PARTICIPANT LIST IMPORTANT NOTE: This list is for the chapter and will be provided to the Exhibitor(s)/Vendor(s) unless you check the “Opt Out” box in front of your name. Opt Out First Name 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 Last Name Phone # Email Organization