Annual Meeting Exhibitor Application & Agreement

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This agreement for the exhibit fee is made by and between the educational provider The Children's Hospital of Alabama, the joint sponsor and requesting organization Alabama Chapter of the American Academy of Pediatrics, and the name of the commercial supporter.

Electronic Signatures below acknowledge the following:

• Arrangements for commercial exhibits cannot influence planning or interfere with the presentation, nor can they be a condition of the provision of commercial support for CME activities.
• It is understood that the fees are paid without any requirement or expectation that products will be purchased and without pressure to prescribe any products.
• It is also understood that the fees are provided without any requirement or expectation that any drugs will be placed upon an organization's formulary.
• Product promotion material or product-specific advertisement of any type is prohibited in or during CME activities. Live staffed exhibits or printed promotional activities must be kept separate from CME. Advertisements and promotional materials cannot be displayed or distributed in the education space immediately before, during, or after a CME activity. Representatives of Commercial Interests will not be allowed to engage in sales or promotional activities while in the space or place of the CME activity.

Make Check Payable to & Remit:
Alabama Chapter-AAP
Tax ID #63-0798492
ATTN: Jill Powell
19 South Jackson St
Montgomery, AL 36104

Inquiries:Jill Powell 334-954-2530, jpowellaap@charterinternet.com

Educational Grants & Support: We are currently seeking educational grants to support the scientific program, and support of refreshment breaks, meals and social functions. To learn more about how to support the educational efforts of the Alabama Chapter-AAP, contact Linda Lee or Jill Powell in the Chapter office at the phone number above.

Deadline: Spaces are limited; to ensure your space, please respond by Friday, August 15, 2010.
Payment is due by September 10, 2010.

Provider: The Children's Hospital of Alabama
Tax ID Number		63-0307-306
Contact Person		Amy Richardson, May 20, 2010
Title		CME Coordinator
Phone Number		205-939-9898
Fax Number		205-939-6108
Email Address		amrich@chsys.org

Education Partner or Joint Sponsor:
Tax ID Number	63-0798492
Contact Person	Linda P. Lee, APR, 5-21-10
Title	Executive Director
Phone Number	334-954-2543
Fax Number	334-269-5200
Email Address	lleeaap@aap.net

* I agree to the above statement with this electronic signature:	Yes, I agree No, I do not agree
* Company Name:
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* Exhibit Fees (choose one):	Commercial Exhibitor - Premium Exhibit Space $1200 (6ft table, 2 chairs, & trash can) Commercial Exhibitor - Standard Exhibit Space $895 (6ft table, 2 chairs, & trash can) Charitable Non-Profit/State Agency-Standard Exhibit Space $600 (6ft table, 2 chairs, & trash can)

* Required Field