HCA 2007 Annual Meeting and Exhibition

A nurse puts medication in a child's eye about 1905; Nurse climbing over roof top in 1909 (Photos supplied by Visiting Nurse Service of New York)

Telehealth patient and nurse (Photo supplied by Visiting Nurse Association of Albany, Saratoga, Rensselaer)

Photo Credits :: A nurse puts medication in a child's eye about 1905; Nurse climbing over roof top in 1909 (Photos supplied by Visiting Nurse Service of New York); Telehealth patient and nurse (Photo supplied by Visiting Nurse Association of Albany, Saratoga, Rensselaer)

Exhibitor Registration Form
Please complete the registration form below to register for the conference and reserve booth space.

Exhibit Hall Map with a list of currently reserved booth spaces.

Exhibit Fees: No more than four exhibitor representatives per booth will be allowed; no exceptions will be made. For your convenience, meals are included in the exhibitor fee.
	HCA Member		Non-Member
8'x10' Booth	By 5/7	After 5/7	By 5/7	After 5/7
1 Representative	$850	$950	$1100	$1200
2 Representatives	$950	$1050	$1200	$1300
3 Representatives	$1050	$1150	$1300	$1400
4 Representatives	$1150	$1250	$1400	$1500

Company:
Event Contact First Name:
Event Contact Last Name:
Title:
Address:
City:
State:
Zip:
Phone:	(Phone Number)
Fax:
Email:	(E-mail)
Website:
Member Status:
Registration:
Booth Number:	Click HERE to view a map and list of currently reserved booths (page will open in a new window/tab). The booth selection drop-down below only lists currently available locations.
Raffle Prize:	Exhibitors are responsible for collecting raffle entries and selecting the winner. HCA will announce the winners. Your prize will be listed in the onsite program booklet. HCA encourages all exhibitors to donate an item in order to maximize your marketing opportunities.
Product/Service Listing: Exhibitors are invited to provide a brief description of the products and services they provide, to be published in the final event program booklet. Please indicate below if you would like to use the listing from last year's program, or provide a new description.
Use same product/service listing from last year?	Yes No
Product/service listing (if new or different from last year):
Additional Representatives: Please indicate below the names of additional representatives from your company that will be participating in the exhibit show, with any special meal requests they have. Note that no more than four exhibitor representatives per booth will be allowed—no exceptions. Also note that you must indicate the correct number of representatives in the registration fee field above.
Representative 1: At a minimum, data must be completed for one representative. If the name and contact information is the same as the event contact person/information above, you can indicate so below and skip those fields. However you must indicate any special meal requests and the awards dinner selection below.
Representative 1 same as event contact above?	Yes No
Name
Title
Address 1
Address 2 (city/state/zip)
Phone
Fax
Email
Special Meals:
Awards Dinner:
Representative 2:
Name
Title
Address 1
Address 2 (city/state/zip)
Phone
Fax
Email
Special Meals:
Awards Dinner :
Representative 3:
Name
Title
Address 1
Address 2 (city/state/zip)
Phone
Fax
Email
Special Meals:
Awards Dinner :
Representative 4:
Name
Title
Address 1
Address 2 (city/state/zip)
Phone
Fax
Email
Special Meals:
Awards Dinner :
Cancellation Policy: It is understood that there will be no refund of the exhibitor fee if the contract is cancelled after May 23, 2007. Cancellation prior to that date requires payment of 25% of the exhibit fee.
Confirmation:	Please click the checkbox below to confirm and "digitally sign" your registration. By doing so, you are agreeing to the cancellation policy above and other terms outlined in the full conference program booklet, including the exhibitor rules and regulations.