Exhibitor Registration Form

Dear Representative,

I would like to take this opportunity to thank you and your company for all of your support for the Phoenix Ophthalmological Society in the past. We are looking to the future and request your continued support in displaying at our upcoming meetings listed below.

  • Thursday, September 19, 2019

  • Thursday, November 7, 2019

  • Thursday, February 13, 2020

  • Thursday, April 9, 2020

The Phoenix Ophthalmological Society will continue to meet at The Scottsdale Hilton. The address is 6333 North Scottsdale Rd., Scottsdale, AZ 85250. The evening will begin at 6 pm with an exhibitor event that takes place prior to our dinner meeting. The exhibitor event is in a separate ballroom from the dinner meeting. As an exhibitor, you are encouraged to arrive at 5:30 p.m. in order to arrange and display merchandise on a six foot table provided for you. If electric is needed, please contact our Executive Director, Shauna Mote. The Scottsdale Hilton does have an additional charge of $50 per event if you require electric. This can be selected on the exhibitor registration form and added to your payment.

We offer 2 status levels for our exhibitors: Preferred and Traditional. Preferred Status allows each company to bring up to 6 representatives and gives you premium location close to the bar, and Traditional Status allows each company to bring up to 3 representatives. The exhibiting fee for Preferred Status is $600 per meeting, and the fee for Traditional Status is $350 per meeting. Please complete the online registration form and request payment in the form of a check as we do not accept credit card payment.

Because of the positive feedback that you have provided, we will continue to offer a raffle to our members that visit each exhibit booth.

We very much appreciate your quick response, and again, I thank you and look forward to seeing you at the upcoming events. If you should have any questions, please feel free to contact me or Shauna Mote. Thank you!

Sincerely,

Sachin Mehta, MD
President

TAX ID # 95-3560011

Registration Form

All fields required.

Dates and Fees
Preferred Status: $600 per meeting or $2,400 for the year. Traditional Status: $350 per meeting or $1,400 for the year. Electric: $50 per meeting or $200 for the year. Please select your status choice and mail payment promptly to: Phoenix Ophthalmological Society Attn: Shauna Mote 4902 W. Lindner Dr., Glendale, AZ 85308 **Credit card payment is NOT accepted
Status *
We offer 2 status levels for our exhibitors. Preferred Status allows each company to bring up to 6 representatives and gives premium location close to the bar. Traditional Status allows each company to bring up to 3 representatives.
Dates *
Please check the date(s) you will be attending.
Electricity
Please check the date(s) you will be needing electricity.
Company Address *
Company Address
Phone *
Phone