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MAOPS Home  MAOPS Membership  NEW: FTC Red  Flags Rule  Preferred Insurance  Provider  Health Hints  Leadership  Scholarship  Applications  Wetzel Scholar  Recipients  MAOPS Resumé  Contact Us  Members Only		+ MOAC Exhibitor Registration Printable MOAC Exhibitor Agreement Form If payment by check is preferred, click this button to print the exhibitor agreement form, complete it, attach a check, and return it to the Wetzel Foundation. Firm Name: Firm Address:   (include street address, city, state, and zip code)   Contact Name: Contact Email: Contact Phone: Contact Fax:   Names of Exhibitor Representatives Attending 2010 MOAC (for name badges):   Name: Name: Name: Name: Name: Name:   The exhibit hall will be located in Windgate Hall at Tan-Tar-A Resort. The room will be decorated with pipe & drape and will hold 76 exhibit booths as shown on the layout. Each 8'x10' booth will include one six-foot draped and skirted table, two chairs, a wastebasket and signage. The rate for one exhibit booth with up to two representatives is $900. The rate for a second exhibit booth with up to two representatives is $600. Additional representatives may be included at $50 per person. Only one product line will be exhibited at each exhibit space. Please refer to the exhibit hall layout and list your choice of exhibit booth(s) below. Your booth will be assigned as soon as payment and the completed exhibitor agreement is received.   Windgate Hall Exhibit Hall Layout               Buffets and Breaks                                                 31 32 33 34 35 36 37 38             39 40 41 42 43 44 45 46     30                     21 56                     47     29 28 27 26 25 24 23 22     20 57     55 54 53 52 51 50 49 48       10 11 12 13 14 15 16 17     19 58     60 61 62 63 64 65 66 67     9                     18 59                     68     8 7 6 5 4 3 2 1             76 75 74 73 72 71 70 69                                                                                 Door                                         Choose your exhibitor space by keying in the appropriate available number from above. (blacked out tables have already been reserved)   First Exhibit Space:        Second Exhibit Space:    Input a booth number or letter in this box only if you want to pay for a second exhibit booth.   The undersigned hereby authorizes the William L. Wetzel Osteopathic Education and Research Foundation (Wetzel) to reserve an exhibit booth for the firm named above for an exhibit at the 112th Missouri Osteopathic Annual Convention Exhibition to be held at Tan-Tar-A Resort, Lake of the Ozarks, Missouri on Thursday, April 8, 2010 through Friday, April 9, 2010. Exhibit setup will begin on Thursday at 8:00 am. Exhibit teardown will begin no earlier than 4:00 pm on Friday. The exhibitor assumes the entire responsibility and liability for losses, damages, and claims arising out of exhibitor's activities on Tan-Tar-A Resort premises and will indemnify, defend, and hold harmless Tan-Tar-A Resort, its owner, and its management company, as well as their respective agents, servants and employees from any and all such losses, damages, and claims. Exhibit space will be assigned upon receipt of the completed exhibitor agreement and payment in full. The undersigned understands that if the requested space(s) is not available, another space will be assigned and notification will be provided by Wetzel. Cancellation of exhibit space will result in forfeiture of the exhibit fee, due to the limited number of spaces available.   Authorizer Name:   Credit Card Information: Name Address City State Zip   Price:

Brian Bowles, Executive Director
Missouri Association of Osteopathic Physicians & Surgeons - Copyright 2010
1423 Randy Lane, Jefferson City, MO 65101
Phone: 573-634-3415   Fax: 573-634-5635   E-mail: contact@maops.org

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