Viscount Suite Hotel

11th Annual Spring Mental Health & Aging Conference
Friday, April 6, 2018

4855 East Broadway Boulevard, Tucson
2018 Summer Conference
Friday, June 22, 2018
Phoenix

30th Annual Fall Symposium
Friday and Saturday
November 30, and December 1, 2018
Phoenix

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.), Medical Directors, NPs, PAs, nurses, social workers, pharmacists, case managers, therapists, long-term care and assisted living facility administrators and 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.

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.

PREMIERE Sponsor / $15,000 / Spring Tucson Summer Phx Fall Phx
SUPPORTING Sponsor / $10,000 / Spring Tucson Summer Phx Fall Phx
PRESENTING (Speaker/Topic) Sponsor / $5,000 / Spring Tucson Summer Phx Fall Phx
CONTRIBUTING Sponsor / $3,000 / Spring Tucson Summer Phx Fall Phx
LUNCH Sponsor / $2,500 / Spring Tucson Summer Phx Fall Phx
BREAKFAST Sponsor / $1,000 / Spring Tucson Summer Phx Fall Phx
SUSTAINING (Morning or Afternoon Break) Sponsor / $750 / Spring Tucson Summer Phx Fall Phx
Please see page 4 for details about sponsorship levels / Morning Break And/Or Afternoon Break
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 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

Thank you for your support of the Arizona Geriatric Society!

EARLY REGISTRATION (Reserve by March 17) LATE REGISTRATION (after March 17)

AzGS MEMBER RATE AzGS MEMBER RATE

$600 For-Profit (per day) $650 For-Profit (per day)

$400 Non-Profit (per day) $425 Non-Profit (per day)

NON-MEMBER RATE NON-MEMBER RATE

$700 For-Profit (per day) $750 For-Profit (per day)

$500 Non-Profit (per day) $525 Non-Profit (per day)

Spring Tucson Summer Phoenix Fall Phoenix

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(s)

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 or call (602) 743-1969
Premiere Sponsor - $15,000 / Contributing Sponsor - $3,000
l / Premiere placement of logo in official online syllabus / l / Placement of logo in official online syllabus
l / Sponsor acknowledgement in social media broadcast / l / Sponsor acknowledgement in social media broadcast
l / Acknowledgement on rotating slide show / l / Acknowledgement on rotating slide show
l / Premium complimentary exhibit table placement / l / Complimentary exhibit table placement
l / Four complimentary meeting registrations / l / One complimentary meeting registration
l / Ad in the Journal of the Arizona Geriatrics Society (full page)
l / Honorary AzGS Healthcare Affiliate membership / Lunch Sponsor - $2,000
l / Acknowledgment on lobby signage / l / Placement of logo in official online syllabus
l / Attendee & Exhibitor breakfast and lunch for two representatives / l / Sponsor acknowledgement in social media broadcast
l / Acknowledgement on rotating slide show
Supporting Sponsor - $10,000 / l / Acknowledgment on lobby signage during lunch
l / Preferred placement of logo in official online syllabus / l / Attendee & Exhibitor lunch for two representatives
l / Sponsor acknowledgement in social media broadcast
l / Acknowledgement on rotating slide show / Breakfast Sponsor - $1,000
l / Preferred complimentary exhibit table placement / l / Placement of logo in official online syllabus
l / Two complimentary meeting registrations / l / Sponsor acknowledgement in social media broadcast
l / Ad in the Journal of the Arizona Geriatrics Society (1/2 page) / l / Acknowledgement on rotating slide show
l / Honorary AzGS Healthcare Affiliate membership / l / Acknowledgment on lobby signage during breakfast
l / Acknowledgment on lobby signage / l / Attendee & Exhibitor Breakfast for two representatives
l / Attendee & Exhibitor breakfast and lunch for one representative
Sustaining Sponsor (Morning And/Or
Afternoon Break) - $750 (Per Break)
Presenting (Speaker/Topic) Sponsor - $5,000
l / Placement of logo in official online syllabus / l / Preferred placement of logo in official online syllabus
l / Sponsor acknowledgement in social media broadcast / l / Sponsor acknowledgement in social media broadcast
l / Acknowledgement on rotating slide show / l / Acknowledgement on rotating slide show
l / Complimentary exhibit table placement / l / Acknowledgment on lobby signage during break
l / Ad in the Journal of the Arizona Geriatrics Society (1/4 page) / l / Attendee & Exhibitor Breakfast for one representative
l / Attendee & Exhibitor Breakfast for one representative / Morning Break And/Or
l / Acknowledgement in print and online schedule / Afternoon Break

Questions may be directed to Iris Sumpter, Program Administrator, at (602) 743-1969