2010 MHIMA Annual Meeting St. Charles Convention CenterSt. Charles, MO
April 28 - 30, 2010
Exhibitor Registration Form
* Required information
* Company:
Contact Information
* First Name:
* Last Name:
* Address 1:
Address 2:
* City:
* State:
* Zip Code:
* Phone:
Fax:
* E-mail:
Website:
Attendance
*
0 1 2 3 4 5 6 7 8 9 10 How many representatives will be in attendance?
Name Badges - Due April 16th
Please list the names and credentials of those representatives that will need an ID badge.ID badges need to be worn at all times for the MHIMA exhibit show, luncheon and other scheduled events. We will NOT be preparing additional badges on-site. We will provide name badges for up to four attendees per booth. The booth price covers the first two vendor representatives. We will need all exhibitor names submitted to us electronically by April 16th. Any badges needed after that date will be the responsibility of your organization.
Please list the names and credentials of those representatives that will need an ID badge.
ID badges need to be worn at all times for the MHIMA exhibit show, luncheon and other scheduled events.
We will NOT be preparing additional badges on-site. We will provide name badges for up to four attendees per booth. The booth price covers the first two vendor representatives.
We will need all exhibitor names submitted to us electronically by April 16th. Any badges needed after that date will be the responsibility of your organization.
First Name Last Name First Name Last Name There is a $45/person charge for each vendor representative after the minimum of two. First Name Last Name First Name Last Name
First Name
Last Name
There is a $45/person charge for each vendor representative after the minimum of two.
2. Booth
All booths are 8’ x 10’ and include pipe and drape back drops (8' back and 36" sides) one 8' skirted table, 2 chairs, 1 waste basket, and an identification sign. Space is subject to availability, and will be allocated on a first paid/first-reserved basis. The decision with respect to allocation of booth space will be binding upon all exhibitors. Exhibit space will not be assigned unless full payment is received. Vendors will be notified of space assignment by April 9, 2010. In the event of conflict or conditions beyond our control, MHIMA reserves the right to rearrange the floor plans. SPECIAL NEEDS/INFORMATION: Click here for SCCC Exhibitor information and forms. Please use the forms to request any special needs such as electrical, internet access, shipping information, printing, etc. You may contact Jennifer Wirtz at the St. Charles Convention Center, jwirtz@stcharlesconventioncenter.com or at 636-896-1801 should you have further questions.
All booths are 8’ x 10’ and include pipe and drape back drops (8' back and 36" sides) one 8' skirted table, 2 chairs, 1 waste basket, and an identification sign.
Space is subject to availability, and will be allocated on a first paid/first-reserved basis. The decision with respect to allocation of booth space will be binding upon all exhibitors. Exhibit space will not be assigned unless full payment is received. Vendors will be notified of space assignment by April 9, 2010. In the event of conflict or conditions beyond our control, MHIMA reserves the right to rearrange the floor plans.
SPECIAL NEEDS/INFORMATION: Click here for SCCC Exhibitor information and forms. Please use the forms to request any special needs such as electrical, internet access, shipping information, printing, etc. You may contact Jennifer Wirtz at the St. Charles Convention Center, jwirtz@stcharlesconventioncenter.com or at 636-896-1801 should you have further questions.
Early Registration $700.00 (on or before 3/30/10)
Late Registration $800.00 (after 3/30/10)
Learn more about the MHIMA exhibitor discounts for Annual Meeting booths
I am interested in the two meeting discount (April 2010 and September 2010) I am interested in the three meeting discount (April 2010, September 2010, and April 2011)
3. Sponsorship Opportunities
CORPORATE SPONSORSHIPDecember 2009 - December 2010 Annual Meeting Booth Only Bronze Silver Gold Platinum $700 $800 after 3/30/10 $300 Actual value $600 $600 Actual value $1,000 $1200 Actual value $3,085 $1500 Actual value $3,535 Booth at Annual Meeting Yes Yes Annual Meeting On-Site Program Advertisement Half page Full page Half page article in MHIMA e-Alert Newsletter Devoted to Vendor’s Business Interests 1 1 Membership e-Blast Sponsorship (name/logo tagline) 2 4 6 MHIMA e-Alert Newsletter Sponsorship 1 1 2 2 Website Banner Ad 3 months 6 months 1 year 1 year Website Vendor Directory Listing through 12/31/10 Yes Yes Yes Yes Full Annual Meeting Registration for 1 participant (excludes pre-meeting sessions) Yes Corporate Sponsorship I am interested in the following corporate sponsorship level: Select One Bronze - $300 Silver - $600 Gold - $1200 Platinum - $1500 If you are not interested in a Corporate Sponsorship, you may also purchase the following items a la carte.
CORPORATE SPONSORSHIPDecember 2009 - December 2010
Annual Meeting Booth Only
Bronze
Silver
Gold
Platinum
$700
$800 after 3/30/10
$300
Actual value $600
$600
Actual value $1,000
$1200
Actual value $3,085
$1500
Actual value $3,535
Booth at Annual Meeting
Yes
Annual Meeting On-Site Program Advertisement
Half page
Full page
Half page article in MHIMA e-Alert Newsletter Devoted to Vendor’s Business Interests
1
Membership e-Blast Sponsorship (name/logo tagline)
2
4
6
MHIMA e-Alert Newsletter Sponsorship
Website Banner Ad
3 months
6 months
1 year
Website Vendor Directory Listing through 12/31/10
Full Annual Meeting Registration for 1 participant (excludes pre-meeting sessions)
Corporate Sponsorship
I am interested in the following corporate sponsorship level: Select One Bronze - $300 Silver - $600 Gold - $1200 Platinum - $1500
If you are not interested in a Corporate Sponsorship, you may also purchase the following items a la carte.
Silent Auction or Raffle
For advertising purposes, a description of the item and item value is needed prior to the meeting.
All prizes will be auctioned in the registration area. Items can range in price from $100-$500 and may be delivered by the vendor on April 28, 2010.
MHIMA Scholarship
Select Scholarship Amount $100 $500 $1000
Annual Meeting Bags
$1,500
Speaker
Meal
$2500
Break
President’s Reception
4. Advertising Opportunities
Companies that participate in advertising for the MHIMA Annual Meeting will be recognized in on-site program, on the MHIMA web page, at your booth, and in person. Advertising will be accepted from both exhibiting and non-exhibiting companies. If you cannot attend, this is a great way to have a presence at the meeting. Upon request, we will provide a letter specifying the amount of your advertising for tax purposes. Let the attendees know which booth you are in! Highlight what you have to offer them for HIM products and solutions! If you are unable to attend the Annual Meeting, let our members know you are still able to meet their needs. Prepayment and space reservation is required for all advertising. Price is net; we do not pay commission on ads placed. All advertisements MUST be camera ready or in a jpg, gif, tif or bmp. Do not submit PDF FILES unless we will be using it as a full page. These files cannot be altered or cut and pasted into the publishing software we use. Please email the file to erin_sweeney@ssmhc.com.
Companies that participate in advertising for the MHIMA Annual Meeting will be recognized in on-site program, on the MHIMA web page, at your booth, and in person.
Advertising will be accepted from both exhibiting and non-exhibiting companies. If you cannot attend, this is a great way to have a presence at the meeting. Upon request, we will provide a letter specifying the amount of your advertising for tax purposes.
Let the attendees know which booth you are in! Highlight what you have to offer them for HIM products and solutions! If you are unable to attend the Annual Meeting, let our members know you are still able to meet their needs.
Prepayment and space reservation is required for all advertising. Price is net; we do not pay commission on ads placed. All advertisements MUST be camera ready or in a jpg, gif, tif or bmp. Do not submit PDF FILES unless we will be using it as a full page. These files cannot be altered or cut and pasted into the publishing software we use. Please email the file to erin_sweeney@ssmhc.com.
On-Site Program:
The Annual Meeting On-Site Program is distributed to all attendees, speakers, and exhibitors at our Annual Meeting - approximately 400 total. Advertising for this program is on a first come first serve basis and due no later than March 29, 2010. Please email the file to erin_sweeney@ssmhc.com
Select One Full Page Half Page - Horizontal Half Page - Vertical Quarter Page Business Card
5. MHIMA Website and Program Information
The information completed in this section will be published in the MHIMA onsite program as well as listed on the website. If you do not submit this form or miss the deadline of March 19, 2010, you will have your name listed in the program, but no description.
The information completed in this section will be published in the MHIMA onsite program as well as listed on the website.
If you do not submit this form or miss the deadline of March 19, 2010, you will have your name listed in the program, but no description.
Company Description
Provide a brief (limit to 150 words) description of the services and products that your organization provides.
Contact Information *Contact Name: *Phone: *E-mail:
*Contact Name:
*Phone:
*E-mail:
Liability for Exhibits - Please take caution with your equipment. MHIMA, The St. Charles Convention Center, or any officer, agent, or employee thereof, shall not be liable for the safety of the exhibitors’ property, its agents, or employees from damage by fire, accident or any other causes, and the exhibitor does hereby release and indemnify MHIMA and The St. Charles Convention Center from any such claim of any kind or nature. Every exhibitor is required to and guarantees to have in force, at their own expense, their own insurance covering their employees not only on workers compensation and the employer’s liability, but also on general public liability, and injury, and accident, and any damage to the exhibitors property. MHIMA and The St. Charles Convention Center shall in no way be held responsible. Proof of insurance must be provided to MHIMA by April 16, 2010. Please contact Barb Beckett at (816) 932-6880 or bbeckett@saint-lukes.org.
Liability for Exhibits - Please take caution with your equipment. MHIMA, The St. Charles Convention Center, or any officer, agent, or employee thereof, shall not be liable for the safety of the exhibitors’ property, its agents, or employees from damage by fire, accident or any other causes, and the exhibitor does hereby release and indemnify MHIMA and The St. Charles Convention Center from any such claim of any kind or nature. Every exhibitor is required to and guarantees to have in force, at their own expense, their own insurance covering their employees not only on workers compensation and the employer’s liability, but also on general public liability, and injury, and accident, and any damage to the exhibitors property. MHIMA and The St. Charles Convention Center shall in no way be held responsible.
Proof of insurance must be provided to MHIMA by April 16, 2010. Please contact Barb Beckett at (816) 932-6880 or bbeckett@saint-lukes.org.
I have reviewed and acknowledge acceptance of the terms and conditions which includes the cancellation policy, insufficient check funds and credit card policy.
I have reviewed and acknowledge acceptance of the liability for exhibits.
* Select Below Yes, I agree to the terms and conditions.
Do you have a question or comment? Please enter below and we will contact you.
Payment options include: Check or credit card If you would like a copy of this completed form, please print this page before you select "continue" and continue with the payment process.
Payment options include: Check or credit card
If you would like a copy of this completed form, please print this page before you select "continue" and continue with the payment process.
Contact Webmaster
Updated: 07/07/2010 All Web content © Copyright 2010 MHIMA. All rights reserved. | Contact us |
