III World Asthma & COPD Forum
Dubai, UAE April 24–27, 2010

Exhibition and Sponsorship Application Form

Company Name (in full):
Contact person:
Title:
Address:
Postal Code & City:
Country:
Telephone (with area code):
Facsimile (with area code):
E-mail:
Web site:

Exhibition

Product Description

Briefly describe your product(s) or service(s). This information will be used as part of the application review process.

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Space Selection(check one)

No. of square meters open space: ______m2 (minimum 9m2). Two free registrations for company representatives for every 9m2.

Stand Type / Price per m2 (€) / Number of m2 / Total (€)
□ In-line / €400 / × / =
□ Island / € 500 / × / =

Payment

All payments must be maid in Euro (€) only. If sending payment by wire transfer, please fax a copy of the application along with a copy of the bank transaction to the Congress Secretariat.

Before December 10, 2009, applications must include a minimum 50% deposit (with the remainder due by March 1, 2010). Applications received after December 10, 2009require full payment.

Applications received and paid in full before November 1, 2009 are subject to a 10% discount.

All prices are subject to a 20% VAT.

Please indicate which of the following ways of payment you have used.

 Bank transfer:Intermediary Bank: Reiffeisen Zentralbank Oesterreich AG, AM Stadtpark 9, Vienna, Austria. Swift:RZBAATWW
Beneficiary Bank:ZAO “MOSSTROYEKONOMBANK”, 78 Profsoyuznaya Str.., Moscow 117393, Russia.
Swift:MOSKRUMM
Beneficiary: INSTITUTE OF IMMUNOPHYSIOLOGY
Account:40703978773000300690 Please add €30.00 as processing fee to Grand Total.
 Visa  Eurocard / Mastercard
Charge my Credit Card No. ______Exp. date _____/_____
Card Holder Name ______Passport No. ______Valid through: ______
Card type: CVV2 No.______or CVC2 No.______(see your card reverse side)
Total amount ______
Date ______Signature ______

A 5% administrative fee and a 3% charge fee will apply for all credit card payments.

Having signed below, I herewith confirm that I have read and am fully aware of the cancellation conditions.
I hereby authorize the Congress Secretariat (Institute, Euroline Intelservice, Congress Hotels, Secretariat)
to debit this credit card account for the total amount due.
I also consent to Congress Secretariat (Institute, Euroline Intelservice, Congress Hotels, Secretariat) debiting or crediting my credit card account
of any subsequent change(s) to the items booked.

Cancellation policy

If an exhibitor wishes to cancel or reduce exhibit space, written notification must be sent to the Congress Secretariat. For cancellation received before November 15, 2009, no refund is issued for the deposit. No refunds will be given for cancellations received after November 15, 2009.

Agreement

We agree to observe the regulations of the exhibition as set in the Exhibitior’s Application Form for the IIIWorld Asthma & COPD Forum. Acceptance of this application by the organizer converts this into a contract for exhibit space.

Authorized Signature / Date
Print Name
Print Title

Mail and fax your application to:

 / III WORLD ASTHMA & COPD FORUM
4, Ostrovityanova Street, 117513 Moscow, RUSSIA
 / (7-495)735-1414
Fax / (7-495)735-1441
E-mail /
Web site /

Sponsorship Opportunities and Their Cost

Major Sponsorship Levels
Platinum / €75,000
Gold / €50,000
Silver / €30,000
Advertising in Congress Materials
Final Program
Inside front or back cover / €2,000
Outside back cover / €3,000
Inside the Program / €1,500
Abstract Book
Inside front or back cover / €2,000
Outside back cover / €3,000
Inside the Abstract Book / €1,500
Abstracts on CD-ROM / €2,000
Other Sponsorship Opportunities
Travel grants / €5,000
Company-sponsored symposium / €9,000
Congress bag / €3,000
Bag inserts
One A4 page advertisement / €800
No more than 4 pages including cover / €1,200
No more than 12 pages including cover / €2,000
Envelope with no more than 10 sheets / €3,000
Conference stationary (notepad & pens) / €2,000
Polo-shirt / €5,000
Lanyard for Badges / €1,000
Logo Display on the Shuttle bus / €800
Gala Dinner / €2,000
Coffee Breaks (per break) / €2,000
TOTAL

Major SponsorshipLevels

Platinum: Euro 75,000

  1. Appointment to the Congress Sponsor Advisory Council, whereby input may be provided on the content of the program including plenary sessions, concurrent sessions and workshops, and major social events.
  2. Sponsorship of a 1.5 to 2-hour major scientific session within the main Congress program.
  3. Premium island exhibit space measuring 27 square meters, with the option to expand (expansion at additional cost).
  4. 50complimentary registration fees.
  5. Six complimentary badges for exhibitors.
  6. Priority on hotel selection.
  7. A credit of Euro10,000 toward sponsorship of one or more items as listed in this Sponsorship Opportunities brochure; additional items will be available for sponsorship at additional cost. Items will include sponsored symposia, and other educational sessions, plus the usual array of items necessary for a successful meeting.
  8. Priority on Exhibition area selection.
  9. Right of the first refusal (along with other confirmed Platinum Sponsors) to sponsor available items.
  10. Complimentary, full-page, 4-color advertisement in the Final Program (specific page position at additional cost) and in the Abstract Book.
  11. One complimentary insert in the Congress bags.
  12. Recognition as a Platinum Sponsor in Congress publications, CD-ROM, on Congress bags and on the Congress Web site.

Gold: Euro 50,000

  1. Sponsorship of a 1.5 to 2-hour “satellite” scientific session including time and space assignment and recognition only; all costs, including speaker fees, a/v, catering, etc. will be additional.
  1. Island exhibit space measuring 12 square meters,with the option to expand (expansion at additional cost)..
  2. 30 complimentary registration fees.
  3. Four complimentary badges for exhibitors.
  4. Priority on hotel selection.
  5. A credit of Euro8,000 toward sponsorship of one or more items as listed in this Sponsorship Opportunities brochure; additional items will be available for sponsorship at additional cost. Items will include sponsored symposia, and other educational sessions, plus the usual array of items necessary for a successful meeting.
  6. Priority on Exhibition area selection.
  7. Opportunity to bid on items listed in this Sponsorship Opportunities brochure before general distribution to all potential sponsors (Platinum Sponsors have right of first refusal).
  8. Complimentary, full-page, 4-color advertisement in the Final Program (specific page position at additional cost) and in the Abstract Book.
  9. One complimentary insert in the Congress bags.
  10. Recognition as a Gold Sponsor in Congress publications, CD-ROM, on Congress bags and on the Congress Web site.

Silver: Euro 30,000

  1. Island exhibit space measuring 9 square meters, with the option to expand (expansion at additional cost).
  2. 10 complimentary registration fees.
  3. Two complimentary badges for exhibitors.
  1. Priority on hotel selection.
  2. A credit of Euro 4,000 toward sponsorship of one or more items as listed in this Sponsorship Opportunities brochure; additional items will be available for sponsorship at additional cost. Items will include sponsored lunch and dinner symposia, and other educational sessions, plus the usual array of items necessary for a successful meeting.
  3. Priority on Exhibition area selection.
  4. Complimentary, full-page, 4-color advertisement in the Final Program (specific page position at additional cost) and in the Abstract Book.
  5. One complimentary insert in the Congress bags.
  6. Recognition as a Silver Sponsor in Congress publications, CD-ROM, on Congress bags and on the Congress Web site.

Companies interested in Platinum, Gold, or Silver Sponsorship should contact the Congress Secretariat.

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