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* Company: |
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Are you a PHIMA Corporate
Sponsor?
Yes
No
Learn
more |
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Contact
Information |
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* First Name: |
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* Last Name: |
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* Address 1: |
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Address 2: |
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* City: |
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* State: |
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* Zip Code: |
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* Phone: |
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Fax: |
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* E-mail: |
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Website: |
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Attendance |
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*
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How many representatives will be in
attendance? |
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Name Badges |
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Please list the
participants that will require name badges. |
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2.
Booth Selection and Special Events
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Booth |
View the
Floor Plan
What are your
choices for preferred booth number?
Premiere Booths are denoted with an
asterisk.
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* |
Packages
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Items included in the booth packages |
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Basic
Single Booth (before 2/1/09 $650;
after 2/1/09 $775 ) |
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Premiere
Single Booth (before 2/1/09 $1200;
after 2/1/09 $1,375) |
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Double
Premiere Booth (before 2/1/09 $1500;
after 2/1/09 $1,675) |
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*
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Electricity
needed?
Yes
No
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Internet access
needed ?
Yes
No
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Monday President's Reception |
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*
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To assist PHIMA with planning for
this event, please indicate how many
representatives will be attending
this Monday event. Additional
tickets can be purchased for this
event.
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Basic Single Booth - 2
Tickets Included
Premiere Single Booth -
3 Tickets Included
Double Premiere Booth- 4
Tickets Included |
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Breakfast Tuesday Morning |
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*
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To assist
PHIMA with planning for this event, please
indicate how
many representatives will be attending this
Tuesday event. Additional
tickets can be purchased for this
event.
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Basic Single
Booth - 2 Tickets Included
Premiere Single Booth - 3 Tickets
Included
Double Premiere Booth- 4 Tickets
Included |
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Tuesday Appreciation Luncheon |
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* |
To assist
PHIMA with planning for this event, please
indicate how additional tickets will
be needed for this Tuesday luncheon.
Additional tickets can be purchased
for this event.
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Basic Single
Booth - 2 Tickets Included
Premiere Single Booth - 3 Tickets
Included
Double Premiere Booth- 4 Tickets
Included |
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Tuesday Vendor Reception |
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*
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To assist
PHIMA with planning for this event, please
indicate how
many representatives will be attending this
Tuesday evening event. Additional
tickets can be purchased for this
event.
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Basic Single
Booth - 2 Tickets Included
Premiere Single Booth - 3 Tickets
Included
Double Premiere Booth- 4 Tickets
Included |
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3.
Sponsorships
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If
you are interested sponsoring an
event or item for the meeting,
please check the applicable box
below.
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4. PHIMA Website
Vendor Information
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The
information completed in this
section will be published in the
PHIMA
vendor book as well as published on
the PHIMA website. We will not be
publishing logos or ads this year. |
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Please list any changes from the
contact information provided above
that
you would like printed
differently in the program (e.g.
contact name,
phone number or email
address).
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* |
Company
Description |
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Enter a concise,
2 paragraph description. |