RESPONSE FORM - 26th ANNUAL CLINICAL VIROLOGY SYMPOSIUM
April 25 - 28, 2010
Daytona Beach, FL
This form replaces the hardcopy "Response Form" of previous years. Please complete the form, and submit by clicking the "Submit" button at the bottom of the form.


*Name of Individual we should  contact in future correspondence 
   *Required Fields
*Title of person named above 
*Company Name 
*Mailing Address 
*City 
 State  COUNTRY
ZIP 
Country Code
*Phone 
 Fax
*Email 
Website
 We will include a link to your website on "Our Exhibitors" page

We would like to exhibit at the 26th Annual Clinical Virology Symposium, April 25 - 28, 2010
(Contribution $1750; $750 deposit due by November 1, 2009. Cancellations are refundable subject to an Administrative Fee of $50. To use Credit Card, complete this form, return to the Exhibitor Info page, and select "Credit Card Payment Form")		 Yes we would like to exhibit
No, we are unable to exhibit this year
We would like additinal exhibit space at $1650 per space (10' x 10' - 100 sq. ft) No:  Yes:  Number of ADDITIONAL spaces:

SYMPOSIUM SUPPORT OPPORTUNITIES
All of the following are considered "Unrestricted Educational Grants," and require that the contributing company complete and submit a "Commercial Support Letter of Agreement" signifying they understand and agree to abide by all requirements of the ACCME Standards for Commercial Support of Continuing Medical Education. All contributors will be recognized in the program.
Platinum Contributor - 4 available Yes, we would like to be a Platinum Contributor

$25,000 Unrestricted Educational Grant Contribution
The Clinical Virology Symposium will recognize Platinum Contributors: their logos printed, on the inside front cover of both the Program Manual and Abstract Manual, and on posters in the Exhibit Hall
Logo will appear on the Symposium totebags, portfolios, and complimentary CDs provided to attendees - due to space limitations on the totebags, portfolios and CDs, it is necessary to limit this opportunity to 4 contributors
First priority in selection of exhibit location, and limited priority in assignment of breakout space
Gold Contributor Yes, we would like to be a Gold Contributor

$15,000 Unrestricted Educational Grant Contribution
Gold Contributors will be identified on the inside front cover of both the Program Manual and Abstract Manual, and on posters in the Exhibit Hall
Logo will appear on Symposium pens.
Silver Contributor Yes, we would like to be a Silver Contributor

$10,000 Unrestricted Educational Grant Contribution
Silver Contributors will be identified on the inside front cover of both the Program Manual and Abstract Manual, and on posters in the Exhibit Hall
Lectureships/Lecture Support

We are interested in establishing/continuing a Named Lectureship
(Contribution $2900 per year for 3 years. INCLUDES one 10' x 10' exhibit space and two exhibitor registrations, You will be contacted to determine which lecture you wish to support)

 Yes:  If yes, please indicate the lectureship title (ex. "XYZ Molecular Lectureship; Edith Hsiung Lectureship):
We would like to support a 2010 lecture
(Contribution $1000. Available to both exhibiting and non-exhibiting companies. You will be contacted to determine which lecture you wish to support. Support will be recognized in program manual as "Supported by XYZ Molecular").
 Yes: 
Catering Support: Varying levels of support are available for each catering event Yes, we would like to support a catering event at the level indicated below
Sunday Dessert Reception Dessert Reception Host - $5,000
Dessert Reception Co-host - $3,000

For all attendees. The Dessert Reception is held in the Exhibit Hall during the opening session of Scientific Posters and Exhibits.
Wine & Cheese Reception Wine & Cheese Reception Host - $5,000
Wine & Cheese Reception Co-Host - $3,000
Wine & Cheese Reception Support - $1000 - $2500 (please indicate support amount in "Comment" section at bottom)

For all attendees. Wine & Cheese Receptions are Monday and Tuesday from 5 pm - 7 pm in the Exhibit Hall.
Continental Breakfast or similar Continental Breakfast Host - $5,000
Continental Breakfast Co-Host - $3,000
Continental Breakfast Support - $1,000 - $2,500
Sunday (expanded brunch break), Monday, Tuesday, and Wednesday mornings, for all attendees
Morning Break Morning Break Host - $5,000
Morning Break Co-Host - $3,000
Morning Break Host Support - $1,000 - $2,500
Daily morning breaks for all attendees
Other Support
Travel Award
Given to students, fellows, and technologists who who submit abstracts for presentation at the Scientific Poster Sessions and a completed PASCV Travel Grant Application, and provide the information and documentation specified on the application. Winners are selected by a committee. The awards are presented at the PASCV Business Meeting, and recipients and donors are recognized at the Symposium Banquet on Monday night.

Named - $1,500 - These awards are generally continued over a period of several years, and are usually named for an individual
General - $750 - These are generally one-time awards

 We would like to offer a named travel award. We would like to name this the Travel Award
We would like to offer a general travel award
Speaker Welcome Baskets
$1,000 - Company name and logo will be included on the welcome basket gift card. Limited to one company		 Yes, we would like to support the Speaker Welcome Baskets
Please contact me to discuss funding opportunities. Contact Name:  Phone No.  Email

We are unable to exhibit in 2010 but would like to support the Symposium in the amount of $
We are unable to support the Symposium in 2010, but wish to receive information about the Program (make sure you complete the contact information at the top of the form.
   
   
Comments: Anything you'd like to tell us, ask us, or discuss? Your comments are welcome:
Please check your responses, then click the button to submit the form to the Clinical Virology Symposium.