Sponsorship & Exhibits Payment Form UPDATE PAYMENT Sponsorship & Exhibits Payment Form UPDATE PAYMENT Sponsorship & Exhibits Payment Form This form is for UPDATES. It is to be used if someone from your organization has already completed the form titled: The University of Illinois Cancer Center: Winter CME Series. Select the conference from the pull down. * Please Select...PAYMENT UPDATE - The University of Illinois Cancer Center: Winter CME Series If you are paying for more than one conference, please submit the payments separately. Which session(s) are you supporting? Sessions * Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Exhibiting Company Name: Exhibiting Company Name: * Company Representative(s) First Name Last Name Email Phone Select all that apply: Attending the conference Organizer/contact for the exhibit Organizer/contact for the product theater plus1 Add minus1 Remove Sponsorship Selections Bronze = $1,750 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Silver = $2,750 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Gold = $4,750 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Platinum = $6,000 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Exhibit Opportunities Bronze = $5,000 Silver = $7,500 Gold = $10,000 Platinum = $12,500 OtherOther S2L Exhibit Opportunities Bronze = $2,750 Silver = $3,750 Gold = $5,750 Platinum = $10,000 SPONSORSHIP DETAILS VIEW AGENDA SPONSORSHIP DETAILS SPONSORSHIP DETAILS Upgrades Exhibitor Spotlight – Dedicated promotional e-Blast = $1,500 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Product Theater = $7,500 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Product Theater Online Live Stream Upgrade = $2,500 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Onsite Meeting Space = $2,500 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH Faculty Dinner = $7,500 Session 1: January 24, 2024 – GU, GI, and Thoracic Oncology Session 2: January 31, 2024 – Women’s Cancers – Year in Review Session 3: February 7, 2024 – Hematologic Malignancies – Update from ASH BCS SPONSORSHIP UPGRADES Exhibitor Spotlight – Dedicated promotional e-Blast = $1,750 Product Theater Morning Product Theater = $12,500 Lunch Product Theater = $17,500 Evening Product Theater = 12,500 Product Theater Online Live Stream Upgrade Product Theater Online Live Stream Upgrade = $5,000 A live online broadcast stream promoted to the national database of 2,000+ past participants S2L Upgrades Exhibitor Spotlight - Dedicated promotional e-Blast (included in Gold & Platinum)= $1,500 Product Theater = $12,500 Thursday Evening Faculty Dinner Sponsorship = $7,500 Product Theater Online Live Stream Upgrade = $5,000 A live online broadcast stream promoted to the national database of 2,000+ past participants NOTE: Only exhibitors are eligible to submit an application for a Product Theater pending approval. Describe the sponsorship update that is being submitted and why. * Billing Information Please Select * Pay Via Check Pay Via ACH/Wire Transfer Pay Via Credit Card NOTE: When the Credit Card form below is completed and submitted, the payment will be processed immediately through Stripe, the credit card processor. Make Checks Payable to: myMedEd, Inc. 518 S. IL Route 31 #194 McHenry, IL 60050 TAX ID: 82-4893155 First Name - Billing * (Name on card) Last Name - Billing * (Name on card) Enter Your Payment Amount * $ Purchase Notes * Address - Billing * Address - Billing Address - Billing Address - Billing Address - Billing Address - Billing State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Address - Billing Credit Card - Billing * If you are human, leave this field blank. Submit Application Δ
