Application for Sponsorship for Exhibitor Space
Application Cutoff Date: 2/22/2012
Research & Educational Sickle Cell Symposium
Exhibition Dates: February 29- March 2, 2012
Instructions
- The persons staffing the booth must be able to set the display unit without the assistance of ladders or chairs.
- With the exception of the display unit behind the supplied 6’ table, a company’s display must be confined to the surface of the table.
- No other furniture is allowed other than the two chairs supplied.
- Pictures or posters cannot be adhered to the walls.
- Electric and Internet access will be available through the Westin Diplomat Hotel and Spa,
954-602-6000, at an additional cost.
Company Name*
Title
Contact First Name*
Contact Last Name*
E-mail Address*
City*
State*
Zip*
Phone Number*
Web Site*
Exhibit Space*
Pay By*
Company Name (if different from above)
Name on Card
CC Number
CC Exp Date
CC Billing Address
Send check/money order with this form payable to:
Memorial Regional Hospital
Sickle Cell Services
3501 Johnson Street
Hollywood, FL 33021
954-265-4422
Memorial Regional Hospital
Sickle Cell Services
3501 Johnson Street
Hollywood, FL 33021
954-265-4422
