SUPPORT CONFIRMATION FORMStep 1 of 250%Name* First Last Company*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe PhoneEmail* Support and Visibility OpportunitiesEducational Grant Opportunities Diamond-$35,000 Platinum-$20,000 Gold-$12,000 Silver-$6,000 Bronze-$3,000Diamond Corporate Visibility Package -One dinner symposium on February 15 or 16 (on a space availability basis) -One 10x20 exhibit space -One banner ad on meeting app -Acknowledged as supporter of scientific posters, main social event, welcome reception, lunches and daily refreshment breaks Acknowledged as Diamond Corporate Visibility Supporter: -With signage, slides and verbal recognition during breaks in scientific session room -In Meeting App -In pre-meeting marketing materials -On NASBS website with hyperlink to company website -In Skull Base Surgery Journal, the official journal of the NASBS -On sign for display in exhibit booth RECEIVE PRE- AND POST-MEETING REGISTRATION LISTPLATINUM LEVEL SUPPORT (Educational Grant): $20,000* ACKNOWLEDGED AS SUPPORTER OF: -Scientific Posters - Welcome Reception - Lunches - Daily Refreshment Breaks ACKNOWLEDGED AS PLATINUM LEVEL SUPPORTER: - On-site with signage, slides and verbal recognition during breaks in session room - In Final Program - In pre-meeting marketing materials - On NASBS meeting app with hyperlink to company website - In Skull Base Surgery Journal, the official journal of NASBS - On sign for display in exhibit booth (booth not included with levels support) RECEIVE PRE- AND POST-MEETING REGISTRATION LIST GOLD LEVEL SUPPORT (Educational Grant): $12,000* ACKNOWLEDGED AS SUPPORTER OF: -Welcome Reception - Lunches - Daily Refreshment Breaks ACKNOWLEDGED AS GOLD LEVEL SUPPORTER: - On-site with signage, slides and verbal recognition during breaks in session room - In Final Program - In pre-meeting marketing materials - On NASBS meeting app with hyperlink to company website - In Skull Base Surgery Journal, the official journal of NASBS -On sign for display in exhibit booth (booth not included with levels support) RECEIVE PRE- AND POST-MEETING REGISTRATION LIST SILVER LEVEL SUPPORT (Educational Grant): $6,000* ACKNOWLEDGED AS SUPPORTER OF: - Welcome Reception - Daily Refreshment Breaks ACKNOWLEDGED AS SILVER LEVEL SUPPORTER: - On-site with signage, slides and verbal recognition during breaks in session room - In Final Program - In pre-meeting marketing materials - On NASBS meeting app with hyperlink to company website - In Skull Base Surgery Journal, the official journal of NASBS - On sign for display in exhibit booth (booth not included with levels support) RECEIVE PRE- AND POST-MEETING REGISTRATION LIST BRONZE LEVEL SUPPORT (Educational Grant): $3,000* ACKNOWLEDGED AS SUPPORTER OF: -Daily Refreshment Breaks ACKNOWLEDGED AS BRONZE LEVEL SUPPORTER: - On-site with signage, slides and verbal recognition during breaks in session room - In Final Program - In pre-meeting marketing materials - On NASBS meeting app with hyperlink to company website - In Skull Base Surgery Journal, the official journal of NASBS - On sign for display in exhibit booth (booth not included with levels support) RECEIVE PRE- AND POST-MEETING REGISTRATION LIST Marketing and Visibility OpportunitiesVisibility Opportunities DIAMOND CORPORATE VISIBILITY PACKAGE: $55,000 SATELLITE SYMPOSIUM OFFICIAL DOOR DROP: $6,000+ PLUS HOTEL CHARGES (1) PILLAR WRAP-$4,000 +PRODUCTION COSTS AND HOTEL COSTS (2) PILLAR WRAP-$7,000 +PRODUCTION COSTS AND HOTEL COSTS EXHIBIT AISLE SIGNS: $4,000 + PRODUCTION AND RIGGING CHARGES KEY CARDS: $3,000 + PRODUCTION (SUBJECT TO HOTEL COSTS) CHARGING STATION-$2,500 PLUS PRODUCTION COSTS MEETING APP ADVERTISING (prices available upon request.) EXHIBITS (prices available upon request.)VODIAMOND CORPORATE VISIBILITY PACKAGE: $55,000 - One dinner symposium on day of your choice (on a space availability basis) - One 10x20 exhibit space - One banner on meeting app - One full-page ad in final program -Acknowledged as sponsor of one refreshment break - Acknowledged as sponsor of the main social eventSATELLITE SYMPOSIA GUIDELINES “Satellite Symposium” refers to any activity that is deemed educational in nature and is independently organized and offered by another organization. APPLICATION SUBMISSION PROCESS AND DEADLINES Please submit the official NASBS Satellite Symposia Application and a proposal. The proposal should include the title of the program and presentations, learning objectives, proposed speaker names, target audience and invitation process. Please note that time and space are limited. Application Deadline: October 25, 2019. CRITERIA FOR ELIGIBILITY Acceptance of the proposed satellite symposium will be based on educational content. The satellite symposium must meet the following criteria: -Provide high-quality information that practicing physicians and surgeons need to provide improved patient care -Offer balanced information and provide an objective viewpoint of the subject matter presented The Organization must: 1. Fulfill any funding obligations 2. Hold NASBS harmless from any and all claims that may result from the meeting NASBS reserves the right to: 1. Limit the number of industry organized events 2. Consult with the organization to assure appropriateness of any activity outcome SCHEDULING The following times are available: -Thursday, February 6, 2020, 6:00 pm – 8:30 pm -Friday, February 7, 2020, 7:30 pm – 9:30 pm Upon receipt of support confirmation form with payment information, a representative from the NASBS office will be in touch with you to confirm the date and time of your symposium. MARKETING NASBS encourages independent promotion of approved symposia. All marketing materials must be approved through NASBS prior to release and distribution. Commercial displays will not be allowed in the meeting room at any time. Signage at the hotel will be allowed only on the day of the symposium. Signs are limited to two in front of the session room, two hours in advance of the symposium. NASBS will promote the program in the following methods: 1. Symposia information is provided in the Advance Program (on the website) and the Final Program (in the meeting app and website) 2. To assist with your marketing efforts, NASBS will provide a pre-registration mailing list Financial Considerations-Direct Costs: All organizations will be responsible for the management of their event’s logistics and payment of direct costs associated with promotion, presenters, catering and audio-visual equipment & labor. Upon NASBS approval of the satellite symposium, the symposium provider will be invoiced for the total due. Payment is expected within 30 business days of invoice issuance. KEY CARDS: $3,000 + PRODUCTION (SUBJECT TO HOTEL COSTS) Want to make a big visual impact? Put your company’s artwork on the hotel room key cards for the NASBS meeting participants. One of the first things attendees will see upon arrival, and something they will continue to use and see everyday is their hotel room key card. Put your company logo and the meeting logo on the hotel room key for high visibility. EXHIBIT AISLE SIGNS: $4,000 + PRODUCTION AND RIGGING CHARGES Draw more traffic to your booth by placing your company name throughout the exhibit hall. Each hanging aisle sign will include your company logo, making it easy for attendees to find your booth. OFFICIAL DOOR DROP: $6,000+ PLUS HOTEL CHARGES Be one of the first companies visible to attendees by having an announcement, invitation, or sales literature hand-delivered to the hotel room of every registered NASBS attendee. Material must be approved by NASBS management in advance. Pillar Wraps Wrap the pillars outside of the entrance to the scientific session room. You may choose to wrap one or two pillars. Your company branding and message will be prominently displayed as attendees make their way into the scientific sessions each day. Contact NASBS Management for specs. All artwork must be approved by NASBS management prior to production. Charging Station Gain extra visibility by sponsoring the charging station for mobile devices. The station will be located in the Registration area, making it highly visible to attendees as they take advantage of the opportunity to charge up their devices throughout the meeting.Meeting App Advertising Put attendees in the palm of your hand by advertising on the NASBS Meeting App for mobile devices. Opportunities will include banner ads, extended company descriptions for exhibitors, inclusion of media items for exhibitors and more.Exhibits The NASBS meeting will feature an exhibit hall with pipe & drape booths. The booth package includes 8' high background drape, 3' high side drape, one (1) exhibitor identification sign, one (1) 6' draped table, two (2) side chairs and one (1) waste basket. Scientific posters will be located in the exhibit hall. Daily refreshment breaks, lunches and the Welcome Reception will be held in the exhibit hall. Please provide me with a list of opportunities and pricesTotal $0.00 Payment MethodCardCheck-please provide invoiceCredit CardAmerican ExpressDiscoverMasterCardVisa Card Number Expiration Date Month010203040506070809101112 Year20202021202220232024202520262027202820292030203120322033203420352036203720382039 Security Code Cardholder Name
