Exhibit Application - 21st Annual Academic Surgical Congress

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Company Name:*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Website*

PRE-SHOW CONTACT INFORMATION

Name*

First Last

Title

Phone*

Email*

Exhibit Reservation and Payment

8×10 Booth space: $4,200 standard fee (on or after November 22, 2024)

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Today

Single 8'X10' Booth*

Price:

Payment Method*

Credit Card

Check or wire transfer – Please send invoice

Payment Options

Full Payment

50% Deposit

Please make check payable to the Academic Surgical Congress and send to:
Academic Surgical Congress
11300 W. Olympic Blvd. Suite 600
Los Angeles, CA 90064

Note- a $500 fee per exhibit reservation will be assessed on all cancellations received on or before January 17, 2025. No refunds will be processed after January 17, 2025.

50% Deposit

$0.00

Total

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

I do not wish my booth to be adjacent to (list no more than 3 companies):

Booths will be assigned at the sole discretion of show management and will be based on the date of request, requested locations, and consideration of competition. Payments must be made in full to secure your booth location. No specific booth guarantees will be made until payment is received.

Exhibitor Agreement*

I certify that I have read the Exhibitor Prospectus which outlines the rules and regulations which are part of this contract. I further certify that all company staff participating in the ASC meeting will abide by the rules and regulations as set forth by the ASC. The ASC will provide industry the opportunity to exhibit and interface with meeting attendees. Exhibit hours, booth location and food and beverage events will be leveraged to encourage registrants to visit exhibit booths

PRE-SHOW CONTACT INFORMATION

Exhibit Reservation and Payment

Note- a $500 fee per exhibit reservation will be assessed on all cancellations received on or before January 17, 2025. No refunds will be processed after January 17, 2025.

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