2020 NANOS Exhibitor-Support Delayed Payment Registration Question Title * 1. Company Name (as you would like it to appear in the program) Question Title * 2. Primary Contact First Name (all exhibit and sponsor correspondence to be sent to this individual) Question Title * 3. Primary Contact Last Name (all exhibit and sponsor correspondence to be sent to this individual) Question Title * 4. Primary Contact Email Address (all exhibit and sponsor correspondence to be sent to this email address, including the invoice for payment) Question Title * 5. Primary Contact Phone Number Question Title * 6. Company Website Address (as you would like it to appear in the program) Question Title * 7. Company Email Address (as you would like it to appear in the program) Question Title * 8. Company Phone Number (as you would like it to appear in the program) Question Title * 9. Company Mailing Address (as you would like it to appear in the program) Question Title * 10. Please provide a 50-word company description (as you would like it to appear in the program): Question Title * 11. Please upload your high resolution company logo for meeting materials here. GIF, JPEG, JPG, PNG file types only. Choose File Choose File No file chosen Remove File Please upload your high resolution company logo for meeting materials here. Question Title * 12. Sponsorship Packages Platinum: $50,000+ Gold: $25,000-$49,999 Silver: $10,000-$24,999 Bronze: $5,000-$9,999 Question Title * 13. A La Carte Opportunities WELCOME/OPENING RECEPTION SPONSOR - $20,000 WALSH DAY LUNCH SPONSOR - $15,000 MEMBER IN TRAINING RECEPTION SPONSOR - $15,000 POSTER RECEPTION SPONSOR - $20,000 ANNUAL BANQUET SPONSOR - $30,000 WIN SYMPOSIUM/HAPPY HOUR SPONSOR - $15,000 YONO LOUNGE SPONSOR - $10,000 BREAKFAST SPONSOR - $10,000 COFFEE BREAK SPONSOR - $5,000 INDIVIDUAL MEETING ROOM (to host individual meetings with clients) - $10,000 INVITED SPEAKER SPONSOR - $20,000 ANNUAL MEETING AUDIO VISUAL SPONSOR AND MOBILE APP SPONSOR - $20,000 KEY CARDS SPONSOR - $7,500 TOTES SPONSOR (provided by supporter, must also include NANOS logo)- $5,000 BADGE LANYARDS SPONSOR (provided by supporter) - $5,000 MEDICAL STUDENT TRAVEL AWARDS - $10,000 RESIDENT/FELLOW AWARDS OR YOUNG INVESTIGATOR AWARD - $5,000 ADVERTISEMENT IN PRINTED PROGRAM FULL PAGE - $1,000Full page dimensions: 8.75” x 11.25” (includes 1/8” bleed) ADVERTISEMENT IN PRINTED PROGRAM 1/2 PAGE - $5001/2 page horizontal dimensions: 8.75” x 5.625” (includes 1/8” bleed) 1/2 page vertical dimensions: 4.75” x 11.25” (includes 1/8” bleed) ROTATING BANNER AD IN MOBILE APP (2 available) - $750 Full Page 4-color ad in March 2020 issue of Journal of Neuro-Ophthalmology- $1,438 (regular price is $2,875) 1/2 Page 4-color ad in March 2020 issue of Journal of Neuro-Ophthalmology- $1,265 (regular price is $2,530) Question Title * 14. Exhibitor Opportunities Single Booth- Early Registration (until Dec. 13th): $2,000 Single Booth- Standard Registration (Dec. 14th- Jan. 1st): $2,500 Double Booth- Early Registration (until Dec. 13th): $3,000 Double Booth- Standard Registration (Dec. 14th- Jan. 1st): $3,500 Patient Advocacy Table- Early Registration (until Dec. 13th): $250 Patient Advocacy Table- Standard Registration (Dec. 14th- Jan. 1st): $450 Question Title * 15. Additional Badges (insert number of badges in text box below)- $250 each Question Title * 16. I understand that cancellations received on or before January 15, 2020 will incur a $200 administration fee. All cancellations received after the deadline will not be eligible for a refund. Cancellations must be submitted in writing to the NANOS Executive Office at meetings@nanosweb.org. Yes Question Title * 17. I agree to the terms and conditions described in the 2020 NANOS Prospectus. Please upload the signed Exhibitor Rules and Regulations Consent Form here. PDF, JPEG, JPG, PNG, GIF file types only. Choose File Choose File No file chosen Remove File I agree to the terms and conditions described in the 2020 NANOS Prospectus. Please upload the signed Exhibitor Rules and Regulations Consent Form here. Please click Done to complete your registration. An invoice will be sent to the email address provided. Please contact Tara Thebeau at meetings@nanosweb.org if you have any exhibit questions or contact Toma Ossian at info@nanosweb.org if you have any sponsor related questions. Done