Exhibitor and Supporter Prospectus - American Society of Gene ...

Exhibit Space Application FormExhibitor InformationThis information will be used for a listing in the Final Program book.*Company Name: ____________________________________________________________________________________________*Contact Person: _____________________________________________________________________________________________*Address: ___________________________________________________________________________________________________*City: ________________________________________________ *State/Province: ________________________________________*Zip/Postal Code :_____________________________________ *Country: _____________________________________________*Telephone: ___________________________________________ *Fax: _________________________________________________*Website: _____________________________________________ *Email: _______________________________________________Contact for Exhibit-Related Information*Contact Person: ______________________________________ *Title: ________________________________________________*Address: ___________________________________________________________________________________________________*City: ________________________________________________ *State/Province: ________________________________________*Zip/Postal Code: _____________________________________ *Country: _____________________________________________*Telephone: ___________________________________________ *Fax: _________________________________________________*Email: _____________________________________________________________________________________________________Booth SelectionPlease check one:BOOTH RENTAL SELECTION For Profit OrganizationNon-profit Organization, Educational Institution,Research Facility10 x 10 In-line Booth: __$2,200 __$2,00010 x 10 Corner Booth: __$2,350 __$2,15010 x 20 Corner Booth: __$3,900 __$3,200Please list your top four booth location choices. (See Exhibit Hall Floor Plan for booth numbers). This does not guaranteeyour preferred booth assignment; ASGCT will make every effort to accommodate your specific request based on availability.Floor plan is subject to change.1. _____________________________________________________ 2. ___________________________________________________3. _____________________________________________________ 4. ___________________________________________________If possible, please do not locate us near the following companies:____________________________________________________________________________________________________________Principal Products to be Displayed__ Publications __ Instruments __ Equipment __ Pharmaceuticals__ Other (please specify): ______________________________________________________________________________________Exhibitor and Supporter Prospectus American Society of Gene & Cell Therapy 15th Annual MeetingPhiladelphia, PA | May 16-19, 201210