If you choose you can download a .pdf version of this form and mail or fax it in instead of filling it out online by clicking here. |
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Company Name: |
Contact Person: |
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Address: |
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City: |
State:
Zip:
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Phone: |
Fax:
Mobile:
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Admin Email (req): |
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Names for Exhibit Badges: |
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YES, I plan to exhibit at the FSO/HNS- FSFPRS Annual Meeting, November 14-16, 2008 at the Ritz-Carlton, Naples in Naples, Florida. We wish to participate this year at the following support level: |
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No, I cannot display or attend the meeting, but would like my company name to appear in the program as a supporter. Enclosed is my check for $200 for that support. |
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We also wish to host/help host the: |
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We will add the following amount onto our check for that sponsorship: $ |
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OR |
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We will pay the hotel directly for hosting a breakfast, coffee or other event with a credit card. |
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Activities
I plan to attend the:
| Friday, November 14, 6 - 7:30 pm |
| Cocktail reception in the Exhibitor Hall |
# attending |
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| Saturday |
| Golf Tournament, Saturday afternoon, November 15, 1:30 pm. PLEASE NOTE: All golf fees will be the responsibility of the player, paid directly to the course pro-shop prior to the start of the tournament. If you cancel inside of 48 hours, your room account will be charged. |
| Name and Hcp |
Name and Hcp |
| Name and Hcp |
Name and Hcp |
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| Cocktail party - Alfresco, Saturday, November 15, 6 - 7:30 pm # Attending |
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Rooms have been blocked at the Ritz-Carlton for those needing overnight accommodations. Costal view rooms are $249 per night plus tax, single or double occupancy. Reserve your rooms by calling (239) 598-3300 and book under the Florida Society of Otolaryngology room block which expires on September 29, 2008.
UPDATE: The Ritz Carlton Beach Resort, Naples, is currently sold out and all rooms within the FSO/HNS room block have been reserved, HOWEVER, we have secured an additional small block at the Ritz-Carlton Golf Resort, Naples (where the FSO/HNS golf tournament will be held), very close by and equally beautiful. There is a shuttle that runs every half hour, 6:30am-11:00pm daily between the two resorts.
Call 239-593-2000 to reserve a room at the Ritz-Carlton Golf Resort, Naples on the FSO/HNS block.
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When you submit this form you will be taken to a payment page to complete this registration. |
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| For security purposes, please type the letters/numbers that you see in the image into the box below. |
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