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63rd Annual M

eeting of th

e American Academy of Maxillo

facial Prosthetics

Saturday, October 1

- Tuesday, O

ctober 4, 2

016

AAMP Administration OfficeRES Seminars4425 Cass Street, Suite A San Diego, CA 92109 USATel: 1 (858) 272-1018Fax: 1 (858) 272-7687E-mail: res@res-inc.comwww.res-inc.com

Jeffery C. Markt, D.D.S.AAMP Program Chair

Meeting InformationThe 63rd annual meeting of the AAMP will be held at the US Grant Hotel in San Diego, California (October 1-4, 2016). The focus of this national session will include topics on cutting-edge technology in head and neck cancer treatment, maxillofacial rehabilitation, management of oral morbidities, and evidence-based supportive care.

The scientific program provides lectures from experts and pioneers in their respective fields, poster presentations, workshops, and continuing education courses advancing mainstream concepts and new developments in head and neck oncology, craniofacial reconstruction, and maxillofacial rehabilitation. Leaders will come together with experts in maxillofacial prosthetics and prosthodontics, oral and maxillofacial surgery, radiation oncology, medical oncology, otolaryngology, speech pathology and supportive care.

Key personnel from leading maxillofacial prosthetic programs and comprehensive cancer centers will be attending this unique meeting. You will have the opportunity to meet many program directors, educators and decision-makers regarding products and technologies at their respective institutions. Additionally, numerous prosthodontic residents and maxillofacial prosthetic fellows will be attending. Our meeting provides you an ideal forum to introduce your company and products to the current leaders of a new class of professionals who will guide the future of our specialties.

From the Program ChairOn behalf of the American Academy of Maxillofacial Prosthetics (AAMP), we would like to offer you an opportunity to market your services to our membership and conference delegates. The AAMP is dedicated to patient care, education, research and outreach. We hope to partner with corporations who share a common vision of maxillofacial rehabilitation.

Our members are experts in the fields of 3D imaging, scanning and prototyping (virtual planning), robotics, biomaterial sciences (nanotechnology), implant bio surfaces, functional outcomes, and preventive measures to protect against the maxillofacial morbidities associated with cancer therapy. Our members are early adapters of new technologies and influence how these new technologies will be used in their academic or private practices. We are a dedicated group of academic, military and private practice professionals who are eager to learn about new products and services such as those you represent.

This meeting prospectus describes several opportunities for corporate support at AAMP annual scientific sessions. Partnering with the AAMP allows instant name recognition with our membership base, year-round branding opportunities and close access to your customer base. By partnering with industry, we are able to prosthetically rehabilitate our patients using cutting edge technology, advancing the care of this special patient population.

Yours Sincerely,

Program ChairDr. Jeffery C. MarktUniversity of Nebraska Medical Center

Department of Otolaryngology- Head and Neck Surgery

981225 Nebraska Medical Center

Omaha, NE 68198

WELCOME

The American Academy of Maxillofacial Prosthetics (AAMP) is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

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Annual Projected Purchasing Power for AAMPAn influential, international fellowship of dignitaries comprised of educators, practitioners and decision makers from prominent institutions and private practices capable of providing significant purchasing opportunities.

AAMP meetings are an ideal venue to display

your company’s products and services!

AAMP ConferenceAdministration

RES Seminars4425 Cass Street, Suite A

San Diego, CA 92109 USATel: 1 858-272-1018Fax: 1 858-272-7687

E-mail: res@res-inc.comwww.maxillofacialprothetics.org

HistoryThe American Academy of Maxillofacial Prosthetics was founded in 1953 by Drs. Aelred C. Fonder, Joseph E. Schaefer, and John R. Thompson. The Academy was originally founded as “The National Association for Somato Prosthetics and Rehabilitation” in Chicago by these three leaders. The Academy was officially incorporated in Cook County (Illinois) and received its charter on January 29, 1953.

ProfileThe American Academy of Maxillofacial Prosthetics is a not-for-profit corporation and is organized and operated exclusively for purposes specified in Section 501©(6) of the Internal Revenue Code. This corporation is formed as a general association of professionals engaged or with an interest in the specialty of maxillofacial prosthetic rehabilitation for the purpose of education, research, and charitable pursuits and not for pecuniary profit. The membership consists of Fellows, Associate Fellows, Life Fellows, Affiliate Fellows, and Allied Health professionals. The corporation exists for the purposes of: patient and professional advocacy, membership development, promote education and research, foster and encourage working relations with dental and maxillofacial laboratory technicians and allied health professionals.

MissionThe AAMP is an association of maxillofacial prosthodontists, dentists, and allied health professionals who are engaged in the art and science of maxillofacial prosthetics. Our mission is to accumulate and disseminate knowledge, experience, and the promotion of research programs involving methods, techniques and devices used in maxillofacial prosthetics. The Academy is devoted to the study and practice of methods used to establish esthetics and function of patients with acquired, congenital, and developmental defects of the head and neck. Additionally, the AAMP promotes enhancement of the oral health of cancer patients who have received radiation therapy or chemotherapy treatment.

DemographicsMembership Number Membership NumberCurrent Membership Paid membership Fellows Associate Fellows Affiliate Fellows Technician Auxiliary

53920411457285

Non-Paid membershipLife FellowsLife Affiliate FellowsStudents

335975233

The AAMP represents 42 USA States, Washington DC, Puerto Rico and 16 International Countries

Clinical Relations: Job Classification:24% Hospitals/Cancer Centers36% University32% Private Practice8% Military

22 Department Heads17 Program Directors5 Board Examiners2 Deans3 Presidents of other organizations

AMERICAN ACADEMY OF MAXILLOFACIAL PROSTHETICS

AAMP PresidentDr. Gerald T. Grant

AAMP Executive Officers

President Elect

Dr. Peter J. Gerngross

Vice President

Dr. Jeffery C. Markt

Vice President Elect

Dr. David J. Reisberg

Executive Secretary/Treasurer

Dr. Thomas J. Salinas

Immediate Past President

Dr. Mark S. Chambers

Recording Secretary

Dr. Alvin G. Wee

AAMP Board of Directors

Dr. David J. Reisberg

Dr. Craig A. Van Dongen

Dr. William R. Wilson

Dr. James A. Kelly

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Saturday, October 1st

12:00-16:00 Exhibit Set-up13:00-16:00 Industry Session 16:30 Poster Set-up17:30-20:00 Poster Session & Exhibit Reception

Sunday, October 2nd

07:15-08:00 Continental Breakfast (exhibit review)08:00-10:00 Plenary Session10:00-10:45 A.M. Coffee Break (exhibit review)10:45-13:00 Plenary Session13:00- 14:00 Lunch with Exhibitors * Over 9 hours of unopposed exhibit time

PROGRAM SCHEDULE

Monday, October 3rd

07:15-08:00 Continental Breakfast (exhibit review)

08:00-10:00 Plenary Session10:00-10:45 A.M. Coffee Break (exhibit review)10:45-13:00 Plenary Session14:30-16:45 Workshop18:30-20:00 Cocktail Reception with Exhibitors (exhibit review)

Tuesday, October 4th

07:15-08:00 Continental Breakfast (exhibit review)08:00-10:00 Plenary Session

10:00-10:45 A.M. Coffee Break (exhibit review)10:45-13:00 Plenary Session14:30-16:45 Workshop

www.maxillofacialprosthetics.org/SanDiego2016 Visit the AAMP website for updated program information and details

Conference Topics• Surgical Reconstruction• Maxillofacial Prosthetics• Facial Prosthetics• Implant Care• Rehabilitation Medicine• Chemotherapy and Radiation

Therapy• Digital Technology• Functional Outcomes• Nanotechnology and Biomaterials• Tissue Engineering and

Regenerative Medicine• Psychosocial Considerations

All clinicians, academics, researchers and industry partners working in the head and neck region such as:• Maxillofacial Surgeons• Head and Neck Surgeons• Otolaryngologists• Plastic and Reconstructive

Surgeons• Prosthodontists• Orthodontists• Radiation Oncologists• Oncologists• Speech and Swallowing• Pathologists• Anaplastologists• Maxillofacial Technicians• Bioengineers• Engineers• Computing Scientists• Software Developers• Regenerative Medicine• Material/Nanoscientists• Health Economists• Researchers• Business Managers/

Administrators

Exhibitor Package Standard Booth Price: $2250.00Exhibit booth includes:

• 10 x 10 booth with 2 exhibitors badges• Company named as Official Meeting Exhibitor

(conference slides)

• Acknowledgment on AAMP Annual Meeting Webpage with link to company webpage• Signage at meeting• Acknowledgement in Conference Program Book

Patron & Exhibit InformationAdditional badges over the complimentary number are $200 each. Additional badges:• Must be for company employee/s (not conference delegate)• Company must provide names of employees (individuals can not register)• Company must pay (not individual)

All exhibit items must be contained within the booth space assigned. If larger booth space is required please contact RES Seminars, planning manager.

Participation in any workshop requires the company to purchase an exhibit booth location, and the Patron/Exhibit fee must be paid prior to company advertisement being placed in the Conference Syllabus Book.

All fees must be paid in full prior to pre-meeting publicity of event with patron logo and acknowledgment on conference web site with link to company webpage.

Who should attend?Colleagues from around the world will present the latest developments, advances and research in the interdisciplinary management of head and neck cancer, trauma, craniofacial and congenital patients.• Latest developments of functional

outcomes and effectiveness of clinical treatment

• Newest technologies designed in the diagnoses, treatment and rehabilitation of the head and neck patient

• Recent advances in research discoveries for the head and neck patient population

• Latest advances in the delivery of interdisciplinary care for this patient population

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Patron PackagesPresidents Dinner: $15,000 Corporate Platinum (Limit 2)Enjoy an evening with the members and officers of the AAMP honoring and presenting awards to our members Corporate Platinum Patron package includes:

• 10x15 booth with 4 exhibitors badges & ribbons• Two (2) full page color ad in Conference Syllabus• Book (inside front cover and/or back cover

included as one of the two pages)• 4 tickets to the President’s Dinner• One e-mail newsflash “Conference - Patron’s

booth” promotion (managed by RES Seminars)• Acknowledgement signage at the

President’s Dinner• Recognition during President’s remarks• Designated: Platinum Patron - slide presentation

• Pre- Meeting publicity with patron logo on mailings

• Acknowledgment on conference website with link to company webpage

• One time use of conference delegate list (manage by RES Seminars)

• Two (2) corporate pop-up signs (located at doors to general session - signs provided by your company

• One piece industry advertising insert in delegate tote bag

• 1 Hotel drop (vendor pays for drop - item gift)

• Company logo: program book• Signage at meeting— Patron & Exhibitor sign• Public recognition at welcome speech• Option for 1 hour presentation

during Industry Session - Saturday, October 26th (first choice of presentation time) and/or elective workshop (based on availability and approval from the Program Committee)

• AAMP digital “Newsletter” branding, with logo and link back to company website (up to 6 issues, based upon commitment date)

Welcome Reception/Poster Presentations: $12,000 Corporate Gold Patron (Limit 1)Posters are presented on topics of interest to conference delegates. Awards are presented and authors are invited to the Presidents dinner to be recognized by Patron and Program CommitteeCorporate Gold Patron package includes:

• 10x15 booth with 4 exhibitors badges & ribbons• One full page color ad in Conference Syllabus Book• 2 tickets to the President’s Dinner• Two (2) corporate pop-up signs (located at

entrance to poster room- signs provided by your company)

• Acknowledgement signage at the Poster Session

• Designated: Gold Patron – slide presentation• Pre-Meeting Publicity of event with patron logo

on mailings• Acknowledgment on conference website with

link to company webpage• Company logo: program book• Signage at meeting— Patron & Exhibitor sign

• Public recognition at welcome speech• Option for 15 minute presentation and/or

elective workshop (based on availability and approval from Program Committee)

• AAMP digital “Newsletter” branding, with logo and link back to company website (up to 3 issues, based upon commitment date)

Coffee Breaks: $10,000 Corporate Silver Patron (Limit 3)Capture attendees’ attention while they gather for continental breakfast and coffee breaks between lectures throughout the day

Corporate Silver Patron package includes:

• 10x10 booth with 4 exhibitors badges & ribbons• One full page color ad in Conference Syllabus Book• 2 tickets to the President’s Dinner (assist with

presentation of awards)• Acknowledgement signage at meeting on

designated day - Sign provided by RES Seminars

• Acknowledgement on announcement slides during designated day - presentation slide provided by RES Seminars

• Designated: Silver Patron – slide presentation• Pre-Meeting Publicity of event with patron logo

on mailings• Company logo: program book

• Acknowledgment on conference website with link to company webpage

• Signage at meeting— Patron & Exhibitor sign• Public recognition at welcome speech• AAMP digital “Newsletter” branding, with logo

and link back to company website (1 issues, based upon commitment date)

Industry Presentation Patron: $5,000 (Limit 1)This package allows the patron to present their industry products/services during a one-hour scheduled Industry Session October 1st.

Industry Session Patron package includes:

• 10x10 booth with 3 exhibitors badges & ribbons• Full page black/white ad in Conference

Syllabus Book• Designated: Presentation Patron –

slide presentation

• 60 minute presentation (upon subject approval from Program Chair)

• Pre-Meeting Publicity of event with patron logo on mailings

• Acknowledgment on conference website with link to company webpage

• Company logo: program book & mailings• Signage at meeting— Patron & Exhibitor sign• Public recognition at welcome speech

Industry Workshop Patron: $3,000 (Limit 4)This event provides patron the opportunity to host a hands-on workshop

Industry Workshop Patron package includes:

• 10x10 booth with 3 exhibitors badges & ribbons• Full page black/white ad in Conference

Syllabus Book• Designated: Workshop Patron – slide presentation

• Elective workshop session• Pre-Meeting Publicity of event with patron logo

on mailings• Acknowledgment on conference website with

link to company webpage

• Company logo: program book & mailings• Signage at meeting— Patron & Exhibitor sign• Public recognition at welcome speech

Standard AV provided by conference (projector and screen). Any additional requests will be the company’s responsibility.

All fees quoted in USA dollarsAll Exhibit times include Food & Beverage served in exhibit area 5

BRANDING and ADVERTISING

Print Advertisement in Annual Session Book Black and white full page: $1,000Black and white half page: $500

Tote Bag: $2,000 (limit1)

Attractive tote bags, imprinted with your company’s name and logo are given to each delegate. This tote will be used to collect handouts from the educational meetings and the exhibit floor. Continue to get your name out throughout the year as members use your tote for their travels.

Plus cost of purchasing, printing and shipping the bags

Promotional Bookmarks: $2,000 (limit 1)

Promo bookmarks will be included in attendees’ registration packet. They will also be available in the registration area.Plus production costs and shipping

Hotel Room Keys: $2,000 (limit 1)

Every time conference attendees open their hotel room doors, they see your company’s name and logo. Patron’s full color logo will be printed on one side of the hotel room key cards.Plus production costs

Jump Drive: $2,000 (limit 1)

Company logo on each jump drive provided to all attendees at registration. Delegates will be encouraged to copy program materials onto their jump drives in lieu of paper copies.Plus jump drive, printing, and shipping costs

Drink Ware: $2,000 (limit 1)

Reusable drinking cups sporting your company logo will be distributed to delegates. These visible takeaways will be carried home by the conference delegation.Plus production and shipping costs

Hotel Door Drop: $2,000 (limit 3)

The Door Drop provides a convenient and unique way to reach your target audience during their stay in New Mexico.Plus hotel fees

Pre - Meeting Email Booth Promotion: $1,000(limit 1 email campaign per company)

An email blast will be sent out to conference delegates promoting our conference and your company products/services with appropriate services/products provided (managed by RES Seminars)

OPPORTUNITIES

Lanyards: $2,000 (limit 1)

Lanyards are a convenient way for attendees to wear conference credentials. Company name will be prominently displayed throughout the meeting if you sponsor the conference lanyards. Lanyards are subject to approval by RES Seminars.

Plus cost of lanyards, printing and shipping

Flashlights: $2,000 (limit 1)

Mini flashlights with your company logo will be distributed to delegates. Giving a useful, practical promotional product will be well received and reflect positively on your company.

Plus cost of flashlights, production and shipping

Note Pads: $2,000 (limit 1)

Your company logo will be on all of those scraps of paper everyone uses to jot notes, new friends’ contact info, and meeting times and places for networking. Note pads imprinted with your name and logo will be in attendees’ registration packet and on the tables in registration area.

Plus any printing and shipping costs of note pads

Pens: $2,000 (limit 1) Pens with your logo will be distributed in the attendees’ registration packets and available on in registration area. Attendees will be reminded of your product whenever they use your pen. Pens provided by patron.Plus shipping cost to meeting

Luggage Tags: $2,000 (limit 1)

Luggage tags will be placed in registration packets providing great exposure for your company. Luggage tags allow attendees to slip in their business card and secure to their briefcase/ luggage, providing long-term visibility for your brand.Plus production and shipping costs

Digital Newsletter: $1,000 (limit 1 newsletter exposure per company)

Company name and link back to company’s website will be included on digital newsletter sent to the AAMP membership.

Additional Advertising Opportunities are available to all. If you choose to be a sponsor or industry partner exhibitor, then you are eligible for a 50% cost reduction in additional advertising opportunity

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EXHIBITOR

Exhibit Dates & HoursContinental Breakfasts, AM and PM breaks and Poster Session/Exhibit Reception. All exhibits must be staffed during open hours.

Dismantling of ExhibitsAll exhibits should remain intact until the official closing time on Tuesday, October 4.

Exhibit Space Fees Include6’ Skirted Table with 2 Chairs Waste Basket Please note that exhibit fees do not include shipping, receiving and handling fees, or booth electrical needs. Payment arrangements are the responsibility of the exhibit company and made directly through the hotel.

PaymentPayment in full for the contracted space must be forwarded with the patron & exhibitor application. The balance must be paid by Friday, April 29th, 2016.

Make checks payable to: AAMP MeetingMail to: RES Seminars4425 Cass St., Suite A, San Diego, CA 92109

Refunds & CancellationsCancellation of sponsorship must be made in writing via certified mail, return receipt requested to:

AAMP / RES Seminars 4425 Cass St., Suite A, San Diego, CA 92109

Phone cancellations will not be accepted. A refund of 50% of the total sponsorship will be granted for cancellations made on or before Friday, April 29th, 2016.

Refunds will not be granted for cancellations made after Monday, August 1st, 2016.

InfringementInterviews, demonstrations and the distribution of literature or samples must be made within the exhibitor’s assigned area. Canvassing or distributing of advertising materials outside the exhibitor’s own space will not be permitted.

Conduct of ExhibitsElectrical or other mechanical apparatus must be muffled so the noise does not interfere with other exhibitors. Character of the exhibits is subject to the approval of AAMP. The right is reserved to refuse applications that do not meet standards or expectations, as well as the right to curtail exhibits or parts of exhibits, which conflict with the character of the conference. This applies to displays, literature, advertising, novelties, souvenirs or conduct of persons.

SecurityThe safekeeping of the exhibitor’s property shall remain the responsibility of the exhibitor. The AAMP and RES Inc. assume no responsibility for any losses sustained by the exhibitor.

Fire ProtectionAll material used in the exhibit area must be flame proofed and fire-resistant in order to conform to the local fire ordinances and in accordance with regulations established by the local fire department. Crepe paper or corrugated paper, flame-proofed or otherwise, will not be permitted. Paper is not to be used in crating merchandise. Display racks, signs, spotlights, and special equipment must be approved before use, and all displays are subject to inspection by the Fire Prevention Bureau. Any exhibits or parts thereof found not to be fireproof will be dismantled. All aisles and exits must be kept clear at all times. Fire stations and fire extinguisher equipment are not to be covered or obstructed.

Exhibit PersonnelAll participants affiliated with exhibits must be registered as an exhibitor or as a conference delegate. Each person will be issued exhibitor’s badges and must be employed by the exhibitor or have a direct business affiliation.

Each company is allotted badges per exhibit level purchased.

INFORMATION

US Grant Hotel

Hotel Room RatesHotel Room Rates $214, plus applicable state and local taxesRooms are quoted exclusive of appli-cable state and local taxes (currently 12.5% per night)

Phone: 619-232-3121

Hotel AccommodationsPlease refer to the official 2015 AAMP website at:2016 AAMP website at: www.maxillofacialprosthetics.org/ SanDiego2016Identify yourself as an “AAMP Delegates” to receive the group rate.

Shipping InstructionsIf you need to ship items to the hotel for exhibiting, please use the follow-ing address:

US Grant Hotel326 BroadwaySan Diego, CA 92109

Company shipping information should include:• Hotel Guest: Company name• Company representative name• Name of meeting “AAMP”• Meeting dates: October 1-4, 2016

Installation of ExhibitsSaturday, October 1st, 201612:00-16:00 Assembly of exhibits during the regularly scheduled conference hours will not be permitted

Space AssignmentApplication deadline for exhibits is Friday, April 29th, 2016. Applications will be accepted after April 29th on a space available basis.

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Please check your support selection below.

Exhibit Packages Platinum Patron: Presidents Dinner: $15,000 Gold Patron: Welcome Reception/Posters: $12,000 Silver Exhibitor: Coffee Breaks: $10,000 Industry Presentation Patron: $5,000 Industry Workshop Patron: $3,000 Standard Booth Price: $2,250

Branding & Advertising Sponsorship Lanyards: $2,000 Flashlights: $2,000 Note Pads: $2,000 Pens: $2,000 Luggage Tags: $ 2,000 Digital Newsletter: $1,000 Black and white full page advert: $1,000 Black and white half page advert: $500 Tote Bag: $2,000 Promotional Bookmarks: $2,000 Hotel Room Keys: $2,000 Jump Drive: $2,000 Drinkware: $2,000 Hotel Door Drop: $2,000 Pre-Meeting Email Booth Promotion: $1,000

LiabilityIt is agreed that all provisions of the “Rules and Regulations” governing this contract for space shall be a part of this contract. The Conference Hotel/Venue, AAMP and RES Inc. are not responsible for loss or damages to any samples, displays, properties or personal effects brought to the exhibit trade show. Exhibitors hold harmless The Conference Hotel/Venue, AAMP and RES Inc. from claims of any nature arising from our occupancy of assigned space or from activities of our employees or representatives. In the event that any damage to the conference site furniture, fixtures, building, or equipment caused by the installation, presence and/or removal of exhibits and exhibit materials the Exhibitor shall reimburse The Conference Hotel/Venue for the cost of such repairs or replacement as may be necessary.

CANCELLATION POLICY AND LIABILITYBy Sponsor/Exhibitor: Cancellation of sponsorship or exhibit space must be made in writing via certified mail, return receipt requested, to AAMP Meeting c/o RES Seminars, 4425 Cass Street, Suite A, San Diego, CA 92109 USA. Phone cancellations will not be accepted. A refund of 50% of the total sponsorship and/or exhibitor fees will be granted for cancellations made on or before Monday, August 1st, 2016. . Sponsorship and exhibit fees will only be refunded to the person who paid the sponsorship or exhibit fees, by the same method as the original payment (i.e. credit card, check, etc.) and in the case of a credit card only to the same credit card used to pay the sponsorship or exhibit fees. Refunds will not be granted for cancellations made after Monday, August 1st, 2016. .

By AAMP: AAMP reserve the right to cancel, shorten, delay, or otherwise alter or change the Joint Meeting in their discretion. If the entire Joint Meeting is cancelled AAMP’s sole obligation is to refund the sponsorship or exhibit fees paid to AAMP for the Joint Meeting by a sponsor or exhibitor. If the Joint Meeting is delayed, shortened or otherwise altered or changed, AAMP may in its discretion refund the sponsorship or exhibit fees paid to AAMP by a sponsor or registrant on a prorated basis, but is under no obligation to do so. Sponsorship and exhibit fees will only be refunded to the person who paid the sponsorship or exhibit fees, by the same method as the original payment (i.e. credit card, check, etc.) and in the case of a credit card only to the same credit card used to pay the sponsorship or exhibit fees. AAMP is not liable for direct, indirect, incidental, consequential, exemplary, punitive, or damages of any other kind, regardless of the nature of the cause of action that may be asserted. AAMP is not responsible and shall not pay for costs or losses associated with travel, airfare, lodging, food, transportation, setup, freight, employee wages, contractor compensation or other costs or losses incurred by a sponsor or exhibitor in connection with the Joint Meeting or as a result of the Joint Meeting being cancelled, shortened, delayed, or otherwise altered or changed. Exhibitors and sponsors are solely responsible for such costs and losses and it is recommended that exhibitors and sponsors consider purchasing sufficient insurance to cover such costs and losses. Under no circumstances shall AAMP’s liability to any sponsor or exhibitor exceed the sponsorship or exhibit fees paid by the sponsor or exhibitor to AAMP in connection with the Meeting.

Copy this page, complete and fax, email or mail with payment.

Company Name

Address

City/State/Zip/Country

Phone Fax

Email – (PLEASE print very clearly. All correspondence will be by email)

Authorized Signature/Date

Booth Contact Name/Email Address/Cell Phone #

Payment MethodPlease select payment method below:

Check (Payable to: AAMP Meeting)

Amount Enclosed: $

Credit Card: MasterCard Visa AmEx

Amount to be Charged: $

Credit Card Number

Expiration Date: month/year * V/MC 3-Digit Code on back AmEx 4-Digit Code on front

Billing Address: Same as above Billing City/State/Zip/Country:

Name as it Appears on Credit Card

Cardholder’s Signature

QuestionsPlease contact RES Seminars (AAMP Meeting Planner) if you have any questions at 1 (858) 272-1018 or via email at: res@res-inc.com

Mail to: AAMP/ RES Seminars, 4425 Cass Street, Suite A, San Diego, CA 92109 USA | Fax to: 1 858 272 7687 | Email: res@res-inc.com

Once AAMP/RES Seminars receives your application, you will be notified regarding approval of your request. 100% of total support fee is due no later than Friday, April 29th, 2016. The application and exhibit space is subject to cancellation and available for resale.

Thank you for your support!

Sponsor and Exhibitor

APPLICATIONAAMP 2016