EXHIBITOR INFORMATION Limited exhibit space is available at the 2015 Improving Critical and Acute Care for Regional Education to be held on July 10-12, 2015 at the John Q. Hammons Convention Center in Rogers, Arkansas. Exhibit fee: $750 per space Exhibit fee includes:  Six foot table with cover  Listing in acknowledgement materials  List of conference attendees  Breakfast, breaks and lunch setup in exhibitor area  One complimentary conference registration Target audience: The program is designed for health care providers involved in the care of patients in the field, emergency departments, and acute and critical care settings. Target audience includes family practitioners, emergency physicians, other specialty physicians, residents, physician assistants, advanced practice nurses, pharmacists, nurses, EMS, trauma administrators, and other healthcare professionals. An exhibit registration form is attached for your convenience. The agenda can be viewed on the conference website at www.icareconference.com. In order to have your space confirmed, please complete the exhibit agreement and return it by email to [email protected], or fax 501-661-7968 or regular mail to UAMS OCME, 4301 W. Markham Street, Slot 525, Little Rock, AR 72205. The UAMS Tax ID# is 71-6046242. ICARE Conference July 10-12, 2015 EXHIBITOR APPLICATION Company Name Contact Name Address City/State/Zip Phone Email Space requirements (electricity, additional space, etc.) Please list all representatives that will be accompanying your exhibit: ______________________________________________________________________________ Exhibitor Name Title ______________________________________________________________________________ Exhibitor Name Title Payment method:  Visa Credit Card #:__________________________________________  MC Expiration date:__________________________ Sec. Code:______  AMX Total amount authorized: ________________________________  Check Signature: _____________________________________________ Make checks payable to: UAMS Office of CME – Tax ID 71-6046242 UAMS College of Medicine Office of Continuing Medical Education 4301 W. Markham St. Little Rock, AR 72205 (501) 661-7962 (office) (501) 661-7968 (fax)