Event Registration - Vermont Optometric Association
VOA Fall Conference 2018 Exhibitor Online Registration & Payment
9/7/18 - 9/9/18

EXHIBIT AND GRANT LETTER OF INTENT Vermont Optometric Association Fall Conference - September 7-9, 2018  at the Woodstock Inn, Woodstock, Vermont
 
 
COMPANY NAME: ________________________________________________________________________
 
NAME OF AGENT/REP: _____________________________________________________________________
 
NAME(s) OF OTHERS ATTENDING: _________________________________________________________
 
 EMAIL: _______________________________________
 
PLEASE COMPLETE THIS FORM and RETURN TO ADDRESS BELOW by July 14, 2018 ************************************************************************************** GRANT OPPORTUNITIES 
 
Platinum Level Unrestricted Educational Grant  $2,000 +     $_______________
 
Gold Level Unrestricted Educational Grant $1,500 -$1,999     $________________
 
Silver Level Unrestricted Education Grant $1,000 - $1,499    $ _______________
 
Other Contribution           $ _______________
 
Event Sponsorship:  Cocktail Reception (Friday)  $1,500.00     $________________
 
Breakfast (Friday or Saturday)  $1000.00               $________________
 
*GRANTS will include 1 table for the exhibit hall.  *Keep in mind Pharmaceutical Companies may not sponsor the cocktail reception or breakfast
 
************************************************************************************** EXHIBIT HALL - September 7 and 8, 2018
 
Before July 14th- $475 ________________       (Includes 1 table and lunch on Saturday for 1 person)   After July 14th - $600   ________________         Additional Saturday Lunch ____________@ $35 each  If you would like to attend the VOA Dinner on Friday night, cost is $85.00/person. Check to attend ___________
 
Check if you will need: Internet:  □ YES  □ NO / Electricity:  □ YES  □ NO
 
TOTAL ENCLOSED:  $_________________
 
Make checks payable to:  Vermont Optometric Association
 
*Registration will close 1 week before the event (September 1st) to allow coordination of set up with the conference center.  Please mail payment with this form to:
 
Vermont Optometric Association c/o Rick DelBianco OD 69 Allen Street, Suite 12  Rutland, VT 05701

Registration ends on September 1, 2018