International Symposium on Biomedical Imaging: From Nano to Macro 16-19 April 2015 ISBI’15 – Sponsor Opportunities You are cordially invited to participate in this exciting gathering of physicians, biomedical engineers, and clinical engineers at our ISBI’15 Symposium. You will have unique opportunities to interact with national and international leaders from academia, industry and government on key R & D and policy issues; further gain visibility in a national and global scale in the field of individualized healthcare. Please select one of the following options. Platinum ($10,000+ USD) 4 complimentary registrations 1 table top display Company logo with a link to Company website on ISBI’15 website Company name on Student Paper Competition Awards (three best student paper awards) Full page Company listing in ISBI’15 program Special recognition during welcome reception and other ceremonies ◊ Please check here if you do not want the tabletop display that is included with your sponsorship Gold ($5,000 USD) 3 complimentary registrations 1 table top display Company logo with a link to Company website on ISBI’15 website ½ page Company listing in ISBI’15 program book Special recognition during welcome reception and other ceremonies ◊ Please check here if you do not want the tabletop display that is included with your sponsorship Silver ($2,500 USD) 2 complimentary registrations 1 table top display ¼ page listing in ISBI’15 program book Company Logo with a link to Company website on ISBI’15 website ◊ Please check here if you do not want the tabletop display that is included with your sponsorship Basic ($1,500 USD - Technical Industry Sponsorship) 1 complimentary registration Company logo listed in ISBI’15 program book Company Logo with a link to Company website on ISBI’15 website Individual Contributors ($500-$1000 USD) Company Logo only on ISBI’15 website 1 CONTACT INFORMATION (for correspondence and conference arrangements) Contact Name _____________________________________________________________________________________________ Organization _____________________________________________________________________________________________ Street Address _________________________________________________ City ________________________________________ State ____________________ Zip/Postal Code_______________ Country _____________________________________ Phone ____________________ Fax _________________________ E-mail_______________________________________ On Site contact Cell Phone Signage at tabletop/table to read (Please use CAPS only if CAPS are preferred) _______________________________________ PAYMENT Check Enclosed (Made payable to “ISBI’15” and must be in U.S. funds drawn from a U.S. bank. EMB contact information on last page) Credit Card information listed below Credit Card Number __________________________________________ Expiration Date _____________________ Cardholder Name ___________________________________________ Security Code _____________________ Cardholder Signature _______________________________________________________________________________ Please charge this card $ AUTHORIZATION I am authorized by my organization to enter into an agreement of conference support at the ISBI’15 IEEE conference as indicated above, and I have carefully read and accept the rules and regulations listed herein. Print Name ______________________________________________________________ Title ______________________________________________________________ Authorized Signature ______________________________________________________________ Date ______________________________________________________________ CHECKLIST and DEADLINES – ISBI’15 Please submit the following: 1. Priority deadline is 2 March 2015. If you submit this application after that date, acknowledgement of your organization will only be on the conference website and not included in the printed program book . 2. Please send final camera-ready art (vector file) electronically to [email protected] by 2 March 2015. 3. Please send Company logo in vector and JPEG format no later than 2 March 2015, so ISBI’15 can post to the website and include in the printed program book. 2 Please complete this form for those individuals who are specifically assigned to staff your exhibit booth or for complementary conference registrations that are included with your sponsorship category (if applicable). CONFERENCE BADGES Complimentary Registration (1) _________________________________________________________________________________________________________________ *Last/Family/Surname *First/Given Name *Company, University or Other Organization *Mailing Address *City US State/Province *Telephone Number *Postal/Zip Code *Country/Region Fax Number *Email Address Complimentary Registration (2) __________________________________________________________________________________________________________________ *Last/Family/Surname *First/Given Name *Email Address Complimentary Registration (3) __________________________________________________________________________________________________________________ *Last/Family/Surname *First/Given Name *Email Address EXHIBIT ONLY BADGES *provides access to exhibit hall only Complimentary Exhibit Badge (1) __________________________________________________________________________________________________________________ *Last/Family/Surname *First/Given Name *Email Address Complimentary Exhibit Badge (2) __________________________________________________________________________________________________________________ *Last/Family/Surname *First/Given Name *Email Address For questions on sponsorship, exhibition, or the application, please contact Janice Sandler at Engineering in Medicine and Biology Society (EMBS) • IEEE • 445 Hoes Lane, Piscataway, NJ 08854 • Telephone: +1 732 562 2673 • Fax: +1 732 465 6435 Website: http://www.embs.org • E-mail: [email protected] 3
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