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www.lakesumter.org ● p.o.box 1578, mount dora, florida 32756 ● 352.742.9902 ● fax 352-742-9910
november 4, 2014
mission inn
howey-in-the-hills, florida
5:00pm—8:00pm
Presenting Sponsor
$5,000
Conference Tote Bags
$2,000
Triple Table
$1,100
Three 8ft. tables with skirting
Double Table
$ 900
Two 8 ft. tables with skirting
Single Table
$ 600
One 8ft. Table with skirting
Priority locations are given after receipt of payment in full and confirmation date,
on a first come, first served basis. Vendors are allowed two (2) representatives with an
additional charge of $25 for each additional company rep.
Special vendor requests:  Wall Location
 Electricity
 Internet
Other: ___________________________________________________
EXHIBITORS are encouraged to provide door prizes to add excitement and additional exposure for your business! You are welcome to use the event Emcee who will come to your
booth for prize descriptions & drawing winners. Or, you can make your door prize donation to
the Gift Table where names will be drawn every 10 minutes.
Door Prize Donation for Gift Table for:
 Physician only
 Medical Staff Personnel
 Both/Either
Description ___________________________________________________________
Want to be the “go to” vendor? Even doctors like to have fun! And everyone likes to win!
Booths who have fun, play on a theme, offer hand’s on experiences and/or have games of
chance attract the most visitors! We will happily advertise your “draw”!
For more information contact:
Carol Millwater,
–
LSMS Executive Director
352-742-9902
[email protected]
Ameriprise Financial Services
Lake-Sumter Medical Society
Azzly
BMO (formerly M & I Bank)
Barrett, Liner & Company
McKesson
BB&T/Charles Chazal Insurance
The Doctor’s Company
Better at Home Home Health
Orlando Medical News
Central Florida Health Alliance
Practice Manager Solutions
Cornerstone Hospice
PNC Bank
Florida Hospital Waterman
Quest Diagnostics
Florida Doctor’s Insurance
REC - UCF
Gilbert Medical Transcription Svc.
Physician’s Dispensing Co.
Healthy Living Magazine
Physician Vein Care of Lady Lake
Hometown Health TV
Campus Rehab Group
InterCommunity Cancer Center
The Garage IT Solutions
Lake Centre for Rehab
South Lake Hospital
Lake Medical Imaging
TWI/Medical Office Resources of Florida
Lake Sumter Community College
Precision Wellness
LCHD Tobacco Prevention
We Care of Lake County
Leesburg Regional Hospital
Please Print or Type
Company Name:______________________________________________________________________
Representative Name: _________________________________________________________________
Title: _______________________________________________________________________________
Address: ____________________________________________________________________________
City: _____________________________________________ State: ________ Zip: _________________
Phone: __________________________________ Fax: _______________________________________
E-mail: _____________________________________________________________________________
Website: ___________________________________________________
PAYMENT POLICY
A minimum 50% non-refundable deposit is required with this application. The balance must be
paid by October 20, 2014. Checks should be made payable to the Lake-Sumter Medical Society.
 Check Enclosed
 AMEX
 Master Card  Visa Card  Discover Card
#:_____________________________________ Total Amount Charged: $_________________
Exp. Date: _____________ Security Code: ________ Zip Code: __________
______________________________________________________________
Cardholder Name (please print)
______________________________________________________________
Cardholder Signature
Your application will be reviewed by the LSMS. If approved a confirmation will be sent to you.
Your signature below indicates that you understand and agree to the terms of the Sponsorship
Contract.
__________________________________________________________________
Want to have some fun with us? As our guests arrive,
we will invite them to participate in a game quizzing them on our vendors.
The winner gets a nice cash prize just like
in the popular game show JEOPARDY!
We’ll give our guests a player’s card as
they arrive, and as they provide the right
“questions” to your “answers” (that they can only get at YOUR booth), you
will check their card and mark their correct answer with your initials! At
the end of the evening we gather the completed cards and draw for as many
winners as we have money to spread around! The overall winner will
receive the lions share!
Sound like fun? To participate, give us some questions about your
business and let us drive visitors to YOUR booth! Email us at
[email protected] and we’ll do the rest!
Sample: The answer is:
They promote, advocate and support
physician’s in the practice of medicine.
The question is: What is Lake-Sumter Medical Society?
2014 Office
Manager
of the Year
This was a huge hit last year!
We are very excited to again sponsor our annual
Office Manager of the Year which brings
even more guests to our EXPO!
We know how hard office managers work at
handling the demands of very hectic and
challenging offices, so we honor them all,
but one lucky gal or guy, is crowned Office Manager of the Year! We
do have fun with this, but the title was an honor and the valuable gifts
were appreciated. YOUR company is encouraged to add to the prizes
awarded to our Office Manager of the Year, 2014, so you can be
recognized as a sponsor of this prestigious award.
Drink
Tickets
SINCE WE STARTED offering Drink Tickets in 2005, vendors who have purchased them all say the same
thing: THEY WORK! Free drinks bring attendees to your booth!
Our guests can only get them…..from YOU!
So, once again we are offering drink tickets to our vendors. A total of 500 tickets (with a limit of 100 per
exhibitor) are available for purchase by registered exhibitors on a first come first served basis. With your
purchase of drink tickets, a “Drink Tickets” sign will be displayed at your booth, bearing the name of your
company, as well as in the Program.
Please check the appropriate box:

100 tickets for $ 175

50 tickets for $ 100

20 tickets for $ 40

10 tickets for $ 25
Payment Information:

Please include drink ticket payment with registration.
Company Name: _____________________________________________________________
All drink tickets sales are final. No refunds will be issued on unused drink tickets.