EXHIBIT/SPONSOR APPLICATION

EXHIBIT/SPONSORSHIP OPPORTUNITIES

Company Name:
Exhibit Coordinator:
Title:
Address:
City: State: Zip Code:
Telephone:
Fax:
Email:
Competitors:

AN APPLICATION AND 5O% DEPOSIT MUST BE RECEIVED IN ORDER FOR YOUR SPACE TO BE RESERVED. THE DEADLINE FOR YOUR FINAL DEPOSIT IS APRIL 1, 2012.

EXHIBIT:
Elite Package $12,000.00
Premium Package $6,000.00
Standard Package $3,000.00

SPECIAL SPONSORSHIP OPPORTUNITIES:
Door drop $2,000.00
Satellite symposia $3,500.00
Meeting bags $3,000.00
Name tags/lanyard $2,000.00
Online post meeting course $5,000.00
Full page ad in exhibitor book $1,000.00
Program book $3,000.00
Welcome bag insert $2,500.00
Office Staff Educational Workshops $1,500.00

Total: $0

WE AGREE TO ABIDE BY THE RULES AND REGULATIONS ESTABLISHED FOR EXHIBITORS

PAYMENT INFORMATION

MAIL, FAX OR EMAIL TO:
AESTHETIC SCIENCE, LLC
983 PARK AVENUE. SUITE 202
NEW YORK, NY 10028
TEL: 212-717-2855
FAX: 866-477-1258
EMAIL: info@nextgenmtg.org

Wire Transfer: Please email info@nextgenmtg.org for details
Check: Please make checks payable to: Aesthetic Science LLC
Credit Card:

Name on Card
Credit Card Type:
Card Number
Expiration Date	Ex: 05/2015
Security Code
NAME BADGES FORM
NAME BADGE #1
NAME BADGE #2
NAME BADGE #3
NAME BADGE #4
NAME BADGE #5
NAME BADGE #6

Any Special Requirements: