2024 Family Medicine POP Supporter/Exhibitor Application

Save my progress and resume later | Resume a previously saved form

Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Your Email:

A Password:

Confirm Password:

All promotional opportunities are subject to CAFP approval to ensure compliance with ACCME guidelines including the standards for commercial support.

Download the 2024 Supporter & Exhibitor Kit.

For questions, contact Anita Charles at acharles@familydocs.org.

Contact Details

Company Name

First Name

Last Name

Phone

Address Line 1

Address Line 2

City

Country

State

Postal Code

Company Information

Website URL to provide attendees (Include full URL)

50-word description of your company and/or products

Supporter Level

Supporter:

Platinum ($15,000)Gold ($10,000)Silver ($7,500)Bronze ($5,000)None ($0)

Exhibitor:

Exhibit Booth Package ($2,800)None ($0)

Other Promotional Opportunities:

Meeting WiFi Access ($8,000)Happy Hour Reception - Exclusive ($5,000)Happy Hour Reception - Shared ($2,500)Saturday Foundation Awards Breakfast ($5,000)Celebration Luncheon - Exclusive ($10,000)Celebration Luncheon - Shared ($5,000)Residency Fair Supporter ($5,000)Sunday Breakfast - Exclusive ($5,000)Sunday Breakfast - Shared ($2,500)SWAG ($1,500 + cost/mailing of item)Treasure Hunt ($100)

Total Amount

Payment Information

Name on Card

Card Number

Code

Billing Email

Save my progress and resume later | Resume a previously saved form

Contact Information