Exhibit Application - 18th Annual Academic Surgical Congress

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
6' Tabletop: $2,000 Early bird fee (prior to November 18, 2022)

6' Tabletop: $2,300 Standard fee (on or after November 18, 2022)

8x10 Booth space: $3,000 Early bird fee (prior to November 18, 2022)

8x10 Booth space: $3,300 standard fee (on or after November 18, 2022)
Booth space options*
Payment Method*
- Credit Card - Full Payment
- Credit Card - 50% Payment
- Check - Please send invoice
- Check - 50% Payment, Please send invoice
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 6, 2023. No refunds will be processed after January 6, 2023.
6' Tabletop
Price:
8x10 Booth space
Price:
50% Deposit
$0.00
Hidden
When should we expect to receive your payment:*
Total
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: 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 6, 2023. No refunds will be processed after January 6, 2023.

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