GIPPCC collaborates with its members to educate, advocate for, and partner with consumers, healthcare providers and the community in order to improve and increase access to palliative care and bereavement services for children and families throughout Illinois. JUNE 11, 2015 GIPPCC EDUCATION CONFERENCE EXHIBIT PROSPECTUS Board of Directors March 25, 2015 Donna Medina, President, Education Committee, Chair Dear GIPPCC Supporter, Mimi Noonan, Vice President Mary Runge, Treasurer Kristen Drago, Treasurer Erin Flanagan, M.D. Joel Frader, M.D., Clinical Committee, Chair Richard Kasper Meggan Mikal Phillip O’Brien Laura Sollenberger Karen Short Lora Wyatt On behalf of the hospitals, hospices, supporting organizations and individual members of the Greater Illinois Pediatric Palliative Care Coalition (GIPPCC), we invite you to participate in the June 11, 2015 GIPPCC Education Conference, entitled Pediatric Palliative Care: From Prenatal Support through Bereavement Services. GIPPCC has a rich history of offering education programming for providers; the June 11 event represents GIPPCC’s second regional pediatric palliative care conference. The conference will be held at The Chateau Hotel and Conference Center located at 1601 Jumer Drive, Bloomington, Illinois 61704. GIPPCC anticipates attendance from approximately 150 pediatric palliative care clinicians from Illinois, Indiana, Wisconsin, Iowa and Missouri. Participating providers include physicians, nurses, administrators, social workers, expressive therapists, chaplains, child life therapists, parents and others interested in pediatric palliative care. These providers represent hospitals, hospices, home care agencies, other organizations that support children with life limiting illnesses, and individuals committed to the advancement of improved care and services for children with potentially life limiting illnesses. Staff Kimberly Downing RN, JD Project Coordinator kdowning@horizonho spice.org Jennifer Misasi PNP-BC Pediatric Palliative Care APN jmisasi@horizonhospi ce.org Molly Heineman GIPPCC Assistant mheineman@horizon hospice.org 833 W Chicago Ave Ste 300 Chicago IL 60642 www.gippcc.org We graciously invite your participation as an exhibitor at this event. Your involvement will help further dialogue between clinicians and supporting resources. Information about exhibit opportunities can be found below. Register as an exhibitor before May 1, 2015 and receive a $50 discount off the exhibitor fee. Additionally, GIPPCC is seeking sponsors for the program. Sponsorship levels at $2500, $1000, and $500 are available. Any sponsorship of this type will be recognized in the program for the event and on our website and Facebook page. Please note that GIPPCC is a 501 (c)(3) non-profit organization. If you are interested in sponsorship opportunities, please contact Molly Heineman at 312-733-8900, or via email at [email protected]. Thank you in advance for your support of GIPPCC and our regional efforts to improve care for children with life limiting illnesses in Illinois. If you have any questions, we warmly welcome you to contact Molly Heineman using the contact information noted in the preceeding paragraph. Take Good Care, Kim Downing RN, JD Project Coordinator, Greater Illinois Pediatric Palliative Care Coalition The Education Committee Members thank you for sharing your time to participate in this programming. Donna Medina, Chair, GIPPCC President, OSF Home Care Services, Peoria Kristen Drago, GIPPCC Secretary, JourneyCare, Barrington Abby Woods, Southern Illinois Healthcare, Carbondale Laurie Mungovan, Joliet Area Community Hospice, Joliet Marg Wydra, Rush University Medical Center, Chicago Mimi Noonan, GIPPCC Vice President, Parent Representative, Veterinary Specialty Center, Deerfield Margaret Rudnik, GIPPCC Consultant, Chicago Karen Short, GIPPCC Board Member, VNA Hospice, Rockford Jennifer Misasi, GIPPCC APN, Chicago Laura Sollenberger, GIPPCC Board Member, Children’s Hospital of Illinois, Peoria Molly Heineman, GIPPCC Assistant, Chicago 2 June 11, 2015 Exhibitor Information All Exhibitors receive the following benefits: A six foot table draped with linen One complimentary conference registration for an exhibit representative Quarter page advertisement space in the conference program Business card sized advertisement in the GIPPCC bi-annual newsletter Listing on GIPPCC website as conference exhibitor for the education event (www. GIPPCC.org) Exhibit Times Thursday, June 11, 2015 7:00 am-7:30 am Set up 7:30 am-8:30 am Registration and Continental Breakfast 11:00 – 11:15 am Morning Break 12:15 – 1:30 pm Lunch Break 2:30 – 2:45 pm Afternoon Break Exhibit Fees Early Bird Special $200 (Full fee must be received prior to May 1, 2015) Regular Fee $250 (Fee received after May 1, 2015) Exhibiting Terms Cancellation/Refund Policy: Any cancellations must be received by GIPPCC in writing. Due to the advance preparations required for this conference, there will be no refunds for cancellations after May 25, 2015. Exhibitor Registration and Payment: The exhibitor agrees to comply with all rules, guidelines and regulations outlined in this document. GIPPCC must receive full payment of the exhibitor fee to reserve space. Payments should be directed to the Greater Illinois Pediatric Palliative Care Coalition or GIPPCC. Exhibitor fees must be paid by May 25, 2015. An exhibitor’s registration for space (page 5 of this prospectus), once received by GIPPCC, constitutes a contract for the right to use the space, subject to receipt of full payment for space rental. Submissions: Ads and logos must be received by the dates indicated below. Any mailings sent to GIPPCC members will be approved by GIPPCC staff prior to publication. Entity name, logo and brief description for the GIPPCC website must be received by GIPPCC no later than 5pm on May 10, 2015. Developed advertisement for conference brochure must be received by GIPPCC no later than 5pm on May 10, 2015. Space Assignment: There will be dedicated exhibitor space within the conference area. Assigned spaces may be transferred or changed by GIPPCC in its sole discretion in response to reasonable requests and safety concerns (for example, avoidance of congestion). Space is limited. GIPPCC reserves the right in its sole discretion to select and approve all exhibitors. Exhibitor Arrival: All exhibitors must register at the registration desk inside the exhibit hall where badges and conference materials will be distributed. All representatives are required to wear badges while in the exhibit area. Exhibitor registration will open at 7am on June 11, 2015. Staffing: Representatives of the sponsoring company must staff exhibit spaces at all times during the exhibit hours. Those solely staffing their exhibit may take brief breaks. Disclosures of Investigation Uses of Products, Devices of Procedure: All exhibitors are required to follow the Food and Drug Administration (FDA) rules and regulations on displayed projects. These rules require disclosure of current FDA status by appropriate labeling and pharmaceuticals. Further information may be obtained from the FDA. 4 Exhibitor Registration Company Information Company Name: Street Address: City/State/Zip: Contact Name: Contact Phone: Contact Email: Name Badge: Second Name Badge: Exhibitor Information (Indicate Chosen Option with an “X” in last column) $200 $250 Early Bird Discount Rate(must register prior to 5/1/15) Traditional Rate Additional Information Electricity (an additional fee of $15 will apply) Other AV Does your exhibit require and electrical outlet? Y N Does your exhibit require additional AV support? (Please specify on line below) Y N **Electricity is available for exhibitors. Please indicate on the registration form if your exhibit needs access to an electrical outlet. The $15 fee associated with electrical access will be the responsibility of the exhibitor. Payment Information Mail exhibitor registration with check payable to GIPPCC to Greater Illinois Pediatric Palliative Care Coalition c/o Horizon Hospice & Palliative Care Attention: Molly Heineman 833 West Chicago Avenue, Suite 300 Chicago, IL 60642
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