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2022-2023 Signature Partnership RegistrationCurt Fischer2022-08-19T18:58:38+00:00

2022-2023 Signature Partnership Agreement

"*" indicates required fields

EMERGENCY MEDICINE LEADERSHIP SUMMIT | NOVEMBER 2, 2022
The Conference Center at SeaTac

2023 SUMMIT TO SOUND | May 7-9 Suncadia Resort in Cle Elum, WA

Company Information

Primary Contact

Primary Contact Name*
Primary Contact Address*

Primary Booth Representative Contact

(This information will be published and distributed to attendees)
Primary Booth Rep Contact Information
Primary Booth Rep Name*
Primary Booth Rep Address

Representatives Staffing Booth

Representatives
To add more reps, push the + button to the right.
First Name
Last Name
Email
 

Exhibitor Information

Company Type
Choose all that apply
Please indicate companies you desire NOT to be located adjacent to (i.e. competitor)

Signature Partnership

Pay in full now ($4500), or pay a 50% deposit now and be invoiced for $2250 in 2023 for Summit to Sound.

2021-2022 Signature Partnership Agreement
Payment Type*
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CREDIT CARD
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date
 

INQUIRIES
Contact Cailey Nickerson, Chapter Executive, at the Washington ACEP office at 206-956-3648 or send emails to admin@washingtonacep.org

2001 6th Ave, Ste 2700, Seattle, WA 98121

Phone: (206) 956-3648

Fax: (206) 441-5863

Executive Director: Cailey Nickerson

© 2022 | Washington Chapter American College of Emergency Physicians | All Rights Reserved | Designed by Lawton
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