Northwest Society of Colon & Rectal Surgeons 2023 Exhibit Registration

Thank you for your interest in exhibiting at the NW Society of Colon & Rectal Surgeons 63rd Annual Meeting on July 19 - 22, 2023 at Skamania Lodge, Stevenson, WA. To register for the meeting, please fill out the information below.

Company Name *

First Name *

Last Name *

Address 1 *

City *

State *

Postal Code *

Business Phone *

Email Address *

Please email me updates

EXHIBIT FEE

PLATINUM LEVEL – $10,000

Maximum appreciation, an opportunity for substantial partnership with the Society
Recognition at Podium through event signage, on final program, and on website
8 complimentary registration
Invitation for 6 representatives to attend the Welcome Reception on Wednesday and Annual Banquet on Friday
Two (6-ft) table top display
Meals and refreshments included for staff
Participation in the Exhibit Passport program
1 email blast to attendees (company content)

GOLD LEVEL – $6,000

Maximum appreciation, an opportunity for substantial partnership with the Society
Recognition at Podium through event signage, on final program, and on website
Acknowledgement as Gold Level Supporter
6 complimentary registration
Invitation for 4 representatives to attend the Welcome Reception on Wednesday and Annual Banquet on Friday
Two (6-ft) table top display
Meals and refreshments included for staff
Participation in the Exhibit Passport program

SILVER LEVEL – $3,500

Recognition at Podium through event signage, on final program, and on website
Acknowledgement as Silver Level Supporter
4 complimentary registration
Invitation for 2 representative to attend the Welcome Reception on Wednesday and Annual Banquet on Friday
One (6-ft) table top display
Meals and refreshments included for staff
Participation in the Exhibit Passport program

BRONZE LEVEL - $2,000

Recognition at Podium through event signage, on final program, and on website
One (6-ft) table top display
2 complimentary registration
Meals and refreshments included for staff
Participation in the Exhibit Passport program

Please choose fee option below: *

Platinum ($10,000)

Gold ($6,000)

Silver ($3,500)

Bronze ($2,000)

REPRESENTATIVE NAMES

1. Rep Name *

1. Email: *

2. Rep Name

2. Email:

3. Rep Name

3. Email:

4. Rep Name

4. Email:

5. Rep Name

5. Email:

6. Rep Name

6. Email:

7. Rep Name

7. Email:

8. Rep Name

8. Email:

Please DO NOT place near the following companies:

Comments

PAYMENT

You have the option to pay by check to be mailed at the following address:

Northwest Society of Colon & Rectal Surgeons

PO Box 2459

Lynnwood, WA 98036

Or Pay by Credit card. Note that there is a 3% service charge added to the total to use credit card payments. Please add that amount below and proceed to the next page.

Payment Option *

Pay by check

Pay by credit card (3% fee)

Current Total:

$0.00

Questions? Please call our office at 206-794-9124 for more information or send an email to nwscrs@gmail.com.

Website: www.nwscrs.org