Exhibitor and Sponsor Prospectus - International Society for ...

3 - 6 June 2012 | Loews Miami Beach Hotel | Miami, Florida, USASupporter Pledge FormContact InformationList your company name as you would like it to appear on anypromotions. (Please print.)Company Name: _______________________________Street Address: _____________________________________________________________________________City, State/Province: _________________________________________________________________________Postcode:_____________________________________Country: ______________________________________Company Telephone:____________________________Company E-mail:_______________________________Company URL:_ ________________________________Contact Person:_____________________________________________________________________________(To whom all exhibitor correspondence should be sent)Contact E-mail:_________________________________Contact Person Telephone:_______________________Logo SubmissionPlease e-mail a copy of your corporate logo toaball@ispdhome.org prior to 20 April 2012 for use onConference signage.Logos should meet the following specifications:• Tiff, jpeg or eps file• High Resolution (at least 300 dpi)• Print ready• Full color preferredPayment MethodCredit Card Payment must be made in U.S. dollars.A $25 surcharge will be assessed to cover any collection fees.A receipt will be provided upon processing. VISA MasterCard AMEX Check #:____________________________________(Checks should be made payable to theInternational Society for Prenatal Diagnosis.)Amount Authorized: $_ __________________________Exclusive Support Levels Special Event $25,000 Lunches $20,000 Opening Reception $15,000 Wireless Internet $10,000 Networking Break $5,000OTHER CONTRIBUTION$ _______________________________Card Number:__________________________________Exp Date:_______________ *CV2:_________________Cardholder Name:______________________________Signature: _ ___________________________________Billing Address:__________________________________________________________________________________________________________________________*The CV2 code is the three digit security code located on the the backof Visa and MasterCards. American Express cards have a four-digitsecurity code located on the front.Sponsorship forms must be received no later than20 April 2012 to qualify for all of the stated benefits.Please fax completed form with payment to+1.434.977.1856 or mail toISPD, 154 Hansen Rd, Suite 201,Charlottesville, VA 22911 USA.7