Caring for Older Adults

Living with Advanced Disease

Annual Fall Symposium

Beatitudes Campus

1610 W. Glendale Avenue, Phoenix, Arizona

October 20 – 21, 2017

Join us as we learn about, from, and with each other aboutproviding

high quality interprofessional careforolder adults living with advanced complex disease.

Dear Supporter of Continuing Geriatric Education:

The Arizona Geriatrics Society annual continuing education conferences offer the opportunity to reach geriatric healthcare professionals from across Arizona – physicians (MD/DO/NDs, geriatricians, family practitioners, internists, hospitalists, ANPs, etc.), NPs, PAs, nurses, social workers, pharmacists, case managers, therapists, long-term care and assisted living facility administrators, chaplains – all of whom are providing geriatric healthcare for older adults in Arizona. Our members span the fields of geriatrics and gerontology; inpatient and outpatient; home and community-based; social services; residential, skilled nursing, and assisted living facilities; financial services; elder law; governmental agencies; and universities.

Sponsors and exhibitors of our annual continuing education conferences gain access to the largest interprofessional gathering of healthcare geriatric and gerontology professionals in Arizona. Each year healthcare professionals gather to network, learn, share their expertise, and support each other at AzGS conferences. Being a sponsor and/or exhibitor offers unique opportunities for your organization to network, market and advertise, and boost your visibility. Your support makes AzGS conferences possible.

1

Thank you for your support of the Arizona Geriatrics Society!

Our Vision

The Arizona Geriatrics Society (AzGS) is the preeminent source of education for

interprofessional geriatric health providers in Arizona.

Our Mission

Is to advance the best healthcare practices for older Arizonans by supporting the education of interprofessional geriatric health providers.

1

SUSTAINING Sponsor / $25,000
ENDURING Sponsor / $15,000
NURTURING Sponsor / $8,000
SUPPORTING Sponsor / $3,500
Please see page 4 for details about sponsorship levels.
Contact First Name (to be shown on Sponsor Roster) / Last Name (to be shown on Sponsor Roster) / Credentials
Company Name (to be shown on Sponsor Roster)
Company Mailing Address
City / State / Zip
Company Email Address (to be shown on Sponsor Roster) / Company Phone (to be shown on Sponsor Roster)

Representative(s) Who Will Staff Your Exhibit Table

Rep1 Name / Rep 1 Email / Rep 1 Phone
Rep 2 Name / Rep 2 Email / Rep 2 Phone
Rep 3 Name (ADDITIONAL CHARGE $100) / Rep 3 Email / Rep 3 Phone

Payment Information

AzGS is a 501(c) (3) non-profit organization, tax ID #86-0598186. Make checks payable to Arizona Geriatrics Society and mail with

this form to: 1934 East Camelback Road, No. 120-419, Phoenix, AZ 85016or email

Enclosed is my check (payable to Arizona Geriatrics Society). Please charge my credit card AmEx MasterCard Visa

$
Credit Card Number / Total Amount to Charge
Name on Credit Card / Expiration Date

Check here to receive your complimentary meeting registration form(s).You may also email us

Thank you for your support of the Arizona Geriatric Society!

EARLY REGISTRATION (Reserve by September 30th) LATE REGISTRATION (after September 30th)

AzGS MEMBER RATEAzGS MEMBER RATE

$600For-Profit$650For-Profit

$400Non-Profit$425Non-Profit

NON-MEMBER RATENON-MEMBER RATE

$700For-Profit$750For-Profit

$500Non-Profit$525Non-Profit

Contact First Name / Last Name / Credentials
Company Name
Company Mailing Address
City / State / Zip
Company Email Address / Company Phone

Representative(s) Who Will Staff Your Exhibit Table

Rep1 Name / Rep 1 Email / Rep 1 Phone
Rep 2 Name / Rep 2 Email / Rep 2 Phone
Rep 3 Name (ADDITIONAL CHARGE$100) / Rep 3 Email / Rep 3 Phone

Payment Information

AzGS is a 501(c) (3) non-profit organization, tax ID #86-0598186. Make checks payable to Arizona Geriatrics Society and mail with this form to: 1934 East Camelback Road, No. 120-419, Phoenix, AZ 85016 or email

Enclosed is my check (payable to Arizona Geriatrics Society). Please charge my credit card: AmEx MasterCard Visa

$
Credit Card Number / Total Amount to Charge
Name on Credit Card / Expiration Date
Exhibit registration includes food, beverages, and admission to the conference for two representatives plus the exhibit space (6’ table with two chairs). There is an additional charge of $100 per person for more than two representatives. For additional information, please email us at

Thank you for your support of the Arizona Geriatric Society!

SPONSORSHIP LEVELS

SUSTAINING Sponsor - $25,000

Priority placement of logo in official online syllabus

Sponsor acknowledgement in social media broadcast

Friday Attendee & Exhibitor Breakfast

Four complimentary meeting registrations

Premium exhibit table placement

Acknowledgement on rotating slide show

Ad in the Journal of the Arizona Geriatrics Society

Honorary AzGS Healthcare Affiliate membership

ENDURING Sponsor - $15,000

Priority placement of logo in official online syllabus

Sponsor acknowledgement in social media broadcast

Friday Attendee & Exhibitor Breakfast

Two complimentary meeting registrations

Preferred Exhibit table placement

Acknowledgement on rotating slide show

Ad in the Journal of the Arizona Geriatrics Society

NURTURING Sponsor - $8,000

Placement of logo in official online syllabus

Sponsor acknowledgement in social media broadcast

Friday Attendee & Exhibitor Breakfast

Two complimentary meeting registrations

Acknowledgement on rotating slide show

SUPPORTING Sponsor - $3,500

Placement of logo in official online syllabus

Sponsor acknowledgement in social media broadcast

Friday Attendee & Exhibitor Breakfast

One complimentary meeting registration

Acknowledgement on rotating slide show

Questions may be directed to Iris Sumpter, Project Coordinator, at

1