SCVBIC 2015 Santa Clara Valley Brain Injury Conference 4th Annual National Conference Santa Clara Marriott Hotel Santa Clara, California February 5 - 7, 2015 SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS — 1 SPONSORSHIP & EXHIBITOR PROSPECTUS The 2015 Santa Clara Valley Brain Injury Conference Welcome to the biggest and best brain injury conference in California! The 4th annual Santa Clara Valley Brain Injury Conference: Building on the Legacy of Coma to Community, will be held February 5-7, 2015 at the Santa Clara Marriott Hotel, Santa Clara, California. This conference is the modernized continuation of the Coma to Community Conference hosted by Santa Clara Valley Medical Center from 1977 through 1995. We anticipate an audience of 500 rehabilitation professional representing a variety of disciplines as well as individuals with brain injury, family members, and caregivers. The 2013 conference was endorsed by the American Congress of Rehabilitation Medicine, the Brain Injury Association of America, and the International Brain Injury Association. The main conference includes two days of multi-disciplinary state-of-the-art educational sessions focusing on issues related to brain injury treatment and research in both a military and civilian population. The 2015 conference will feature four halfday pre-conference workshops as an optional add-on. Past speakers have included former NFL player George Visger; Co-founder of the Sports Legacy Institute, Chris Nowinski; Vice President for Global Accessibility at Yahoo, Alan Brightman; the Central Park Jogger, Trisha Meili; and President of the American Congress of Rehabilitation Medicine, Tamara Bushnik. The 2015 main conference will have four track-based concurrent sessions: 1. Medical Complexity and Acute and Chronic Treatment (successful strategies and new approaches) 2. Innovative Interventions and Assistive Devices (new technology, stem cells and others) 3. Living After Brain Injury (socialization, relationships, advocacy and caregiving) 4. Special Populations (military and veteran issues, cultural competence, pediatrics, and aging) The conference curriculum will appeal to social workers, therapists, psychologists, physiatrists, nurses, researchers, administrators, advocates, individuals with brain injury and family members affected by brain injury. Presentation format will include lectures, panel discussions, and interactive workshops. Peer reviewed symposia and poster presentations will be an integral part of the program allowing for the sharing of information regarding research and innovative multidisciplinary treatment approaches. In addition to faculty, comprised of national and international recognized leaders in the field of brain injury and rehabilitation, there will be exhibitors sharing the latest innovations and information regarding services for individuals with brain injury and their families. We have expanded exhibit space to allow for additional resources to be shared with our conference attendees. With the resort-like but low distraction setting of the Santa Clara Marriott Hotel conference center, attendees will have the best of both worlds with the combination of stimulating information in a relaxed and intimate setting. For more information on the conference please visit braininjuryconference.org 2 — SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS CONFERENCE FINANCE ADMINISTRATION HOTEL INFORMATION Conference finance administration is being facilitated by the VMC Foundation. Since 1988 the VMC Foundation has worked to raise funds and awareness for the entire Santa Clara Valley Health & Hospital System. Supporting programs where traditional resources fall short, the VMC Foundation is meeting our growing healthcare crisis head on. For more information or to contribute, please visit www.vmcfoundation.org Located in the heart of Silicon Valley, the Marriott Hotel is minutes from the Santa Clara Convention Center, San Jose International Airport, and located next to Intel, McAfee, and EMC. Adjacent to our hotel, guests can also enjoy all the rides and thrills of California’s Great America amusement park. Our hotel in Santa Clara, CA features complimentary Wi-Fi in all public areas, an outdoor heated lap pool and fitness center. Located on-site, is Bradley Ogden’s award winning Farm to Table Santa Clara restaurant, Parcel 104, where Executive Chef Jonathan Hall serves delicious and fresh Northern California cuisine. Find spacious guest rooms offering outdoor balconies with screen doors, luxurious bedding and tiered high-speed wired / Wi-Fi Internet access. Hotel is $109 for a standard single and $119 for a standard double at the conference rate, taxes and incidentals not included. Available 02/05/15-02/08/15. Reservations will be made by individual attendees by calling Marriott Reservations directly at +1.800.228.9290 or via the conference website. The cutoff date for reservations is January 15, 2015. All reservations must be accompanied by a first night room deposit or guaranteed with a major credit card. Past Conference Attendees Past conference attendees have included a wide variety of clinicians, researchers, legal practitioners, agency representatives, advocates, individuals with injuries and family members. Agencies represented are listed below. 9-11 HelpAmerica Foundation Islands Office of Vocational Rehabilitation Melvin E Irvin Disability Representative Inc St. Jude Medical Center Alameda County Medical Center Defense and Veterans Brain Injury Center Mercy General Hospital Stanford University Active Relationships Center Department of Rehabilitation New York University Medical Center Summit Medical Center Alexander Law Eastside Rehab PTPC Oakland Childrens Sutter Rehabilitation Institute Alliance Labs El Camino Hospital - Los Gatos Pate Rehabilitation Alta Bates Summit Medical Center ESPN PeaceHealth Southwest The Frank Stein & Paul S. May Center for Low Vision Rehabilitation Blue Sky Sports & Entertainment Health Plan of San Joaquin Rehab Care Brain Injury Homes, Inc. HealthSouth Rehabilitation Hospital of Vineland Rehab Without Walls Brain Rehabilitation and Injury Network Brookhaven Hospital Cabrillo College California State University, East Bay California Statewide Collaborative for our Military and Families Hilo Medical Center Home Care Assistance Intelius Kaiser Foundation Hospitals Kentfield Rehab Hospital The LCS Edge Rehabilitation Hospital of Indiana Thought Field Therapy Inc TIRR Memorial Hermann Twin Learning LLC ReMed Richard J. Staskus Law Firm Saint Francis Memorial Hospital Samaritan Hospital US Department of Education/OSERS/NIDRR Vancouver Coastal Health Veterans’ Affairs Visger & Associates CareMeridian Kessler Foundation Research Center San Francisco Institute for Hyperbaric Medicine Casa Colina Kessler Institute for Rehabilitation San Jose State University WETA Center on Brain Injury Research & Training Western Oregon University Kindred Healthcare SanBio World Innovation Institute Leon S. Peters Rehabilitation Center Santa Clara Valley Medical Center Yahoo Loma Linda University Medical Center Scheiman Rebuild Fitness Lucile Packard Children’s Hospital Shea and Shea Law Corporation Ludlow Law Office Silicon Valley Independent Living Center Central Coast Center for Independent Living Centre for Neuro Skills College of Alameda Wellness Strategies PC And more... Commonwealth of the Northern Mariana SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS — 3 Exhibit Opportunities Exhibit booths will be set up throughout the duration of the conference. During breaks, all food items are available in the exhibit area to ensure activity. Exhibitors will be listed within the conference program and have access to all main conference educational sessions. Hosting an exhibit is a great way to increase your visibility and support the conference! NON-PROFIT EXHIBIT • One full complimentary registration to the main conference (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) • All conference breaks, meals, and the reception • One 6 foot table with drapery & chair • 500 character exhibitor description in program • Copy of attendee list • Listing on website as exhibitor • $800 early registration ($1000 after 11/30/2014) STANDARD EXHIBIT • One full complimentary registration to the main conference (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) • All conference breaks, meals, and the reception • One 6 foot table with drapery & chair (recommended to remove valuables nightly; not secure overnight) • 500 character exhibitor description in program • Copy of attendee list • Listing on website as exhibitor • $1250 early registration ($1500 after 11/30/2014) PREMIUM EXHIBIT • One full complimentary registration to the main conference (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) • All conference breaks, meals, and the reception • One 6 foot table with drapery & chair (locked overnight, no nightly break-down needed for valuables) • Electricity • 500 character exhibitor description in program (+logo) • Copy of attendee list • Listing on website as exhibitor • $1500 early registration ($2000 after 11/30/2014) 4 — SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS 2015 Conference Exhibit Placement Exhibit placement is first-come, first served, so make your reservations early to secure the best location. Location will be confirmed upon receipt. Past Conference Exhibitors Alliance Labs-Enemeez College of Adaptive Arts Continuity Care Home Nurses National Institute on Disability and Rehabilitation Research San-Bio American Congress of Rehabilitation Medicine CVH Home Health Services Neuropychology Associates Santa Clara Valley Medical Center Avanir Pharmaceuticals Defense and Veterans Brain Injury Center North Coast Medical Scheiman Rebuild Fitness Brain-Aid Dick Alexander Law Firm Oxy Health, LLC Services for Brain Injury Hocoma, Inc. Pacific Medical Shea & Shea Law Firm Home Care Assistance Pate Rehabilitation Shield Healthcare Kay’s Coaching & Expressive Arts Patterson Medical Solutions at Santa Barbara Kentfield Rehabilitation & Specialty Hospital ProtoKinetics Stratus Pharmaceuticals VMC Foundation ATG Rehab Brain Injury Association of California BrainFx, Inc. Burr Pilger Mayer Accountants and Consultants San Francisco General Hospital Kershaw Cutter & Ratinoff QuesGen Systems, Inc. California Telephone Access Program Kindred Hospital /Rehab Care Rehab Care CareMeridian Lash & Assoc. Publishing/Training, Inc. Rehab Without Walls War Related Illness & Injury Study Center (WRIISC) Casa Colinas Centers for Rehabiliation Learning Services Rehabilitation Care Coordination Whole Foods Market Centre for Neuro Skills MediServ Rescare (Gentiva) Wolters Kluwer Heath Mobility Works Restorative Therapies, Inc. Bryman Healthcare Century Council Past Exhibitor Comments “We were new to this event and found the participants very eager to know about us and our products.” “We enjoyed networking with the other vendors, seeing new inventive treatment approaches (potential supplier for us) and exposing clients/families/caregivers/therapists to our unique therapy products. There was a great variety of therapists and medical providers who were able to learn about our new products (PT, OT, ST, RT).” “Attendees represented a great cross section of providers and expertise at upper level for decision making on products and programs.” “Since we are located in Southern California, this was a good opportunity to network with individuals and businesses in the Northern California area.” “There were a lot of people interested in TBI research!” “Thanks for creating an inspiring and informative conference. The event ran smoothly.” “Conference staff were great to work with!“ “This was one of the best conferences I have exhibited and presented at!” “Staff were very helpful, positive and approachable.” SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS — 5 Sponsorship Opportunities Individuals and organizations can make a lasting impression on SCVBIC attendees by helping to support the conference as a Silver, Gold, or Platinum Sponsor. With increased levels of support come increased benefits. SILVER SPONSOR 1. 2. 3. 4. 5. 6. 7. 8. 9. $2500 Investment One full registration to the main conference (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) All conference breaks, meals, and the reception Name listed on onsite signage A badge ribbon indicating distinguished level of support A listing by sponsorship level within the conference program Logo on recognition slides during conference breaks Logo in sponsor section w/500 character statement Use of attendees list Listing on conference website as silver sponsor GOLD SPonsor $5000 Investment 1. Complimentary standard exhibit booth including one complimentary registration (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) 2. All conference breaks, meals, and the reception 3. Logo listed on onsite signage 4. A badge ribbon indicating distinguished level of support 5. A listing by sponsorship level within the conference program 6. Logo on recognition slides during conference breaks 7. Logo in sponsor section w/500 character statement 8. Half page ad within the printed conference program 9. Use of attendees list 10. Inclusion of 1 Powerpoint ad slide rotating continuously throughout all conference breaks. 11. Listing on conference website as gold sponsor PLATINUM SPONSOR $10000+ Investment 1. Complimentary premium exhibit booth including one complimentary registration (additional pre-conference & full conference registrations may be purchased for staff, clients, etc.) 2. All conference breaks, meals, and the reception 3. Logo listed on onsite signage 4. A badge ribbon indicating distinguished level of support 5. A listing by sponsorship level within the conference program 6. Logo on recognition slides during conference breaks 7. Logo in sponsor section w/500 character statement 8. Full page ad within the printed conference program 9. Use of attendees list 10. Inclusion of 1 Powerpoint ad slide rotating continuously throughout all conference breaks. 11. Listing on conference website as platinum sponsor 12. Special recognition at the reception 13. Physical banners in main area 14. Insertion of 1 sponsor provided promotional item for each attendee’s conference bag 15. Verbal acknowledgement and recognition during the opening and closing general sessions 16. Listing of sponsorship on program cover 6 — SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS Sponsorship Opportunities SESSION/EVENT SPONSORSHIP The following opportunities are available as additional marketing opportunities throughout the conference: VOLUNTEER T-SHIRT LOGO FLASH DRIVE SPONSOR • • • • Your logo printed along with other t-shirt sponsors on the back of all volunteer t-shirts to be worn throughout the conference $200 investment (ten available or $2000 for exclusive logo placement) MATERIALS TABLE • • • Your company brochure/newsletter/flyer displayed on an information table near registration Group listing in conference program encouraging people to stop by materials table $250 investment MEETING BAG INSERT SPONSORS • • One sponsor supplied promotional item/flyer placed in every attendee’s meeting bag $500 investment WIFI SPONSOR • • • Listing on conference website as WIFI sponsor Postcard insert in all conference bags with internet login instructions on one side and your company’s half page ad on reverse Logo in sponsor section w/500 character statement • $2500 investment (one available) LANYARD SPONSOR • • • Listing on conference website as lanyard sponsor Your company name and logo on lanyard Logo in sponsor section w/500 character statement • $2500 investment (one available) MEETING BAG SPONSOR • • • • Each conference attendee, exhibitor, and supporter will receive a tote bag to hold conference and exhibit materials. Your company will have its logo or advertisement displayed on one side of the bag Logo in the conference program as a meeting bag sponsor w/500 character statement $5000 investment (one available) • • • Listing on conference website as flash drive sponsor Your company logo on flash drive along with conference logo Logo in sponsor section w/500 character statement Inclusion of 1 Powerpoint ad slide rotating continuously throughout all conference breaks. $5000 Investment (one available) SCHOLARSHIP SPONSOR • • • • • • • • • Listing on conference website as scholarship sponsor 1 full page ad in conference program 2 full-conference registrations (additional pre-conf. & full conf. may be purchased for staff, clients, etc). Logo in sponsor section w/500 character statement Use of attendees list Insertion of 1 sponsor provided promotional item for each attendee’s conference bag Inclusion of 1 Powerpoint ad slide rotating continuously throughout all conference breaks. Verbal acknowledgement and recognition during the opening and closing general session $10000 investment (one available) LUNCH PRESENTATION SPONSOR • • • • • • • • • • • • Listing on conference website as lunch presentation sponsor 1 full page ad in conference program Inclusive of all food & beverages Sponsor created 30 minute panel/speaker 2 full-conference registrations (additional pre-conf. & full conf. may be purchased for staff, clients, etc). Onsite signage at lunch Logo in sponsor section w/500 character statement Use of attendees list Insertion of 1 sponsor provided promotional item for each attendee’s conference bag Inclusion of 1 Powerpoint ad slide rotating continuously throughout all conference breaks. Verbal acknowledgement and recognition during the opening and closing general sessions $12500 investment (two available) SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS — 7 Sponsorship Opportunities Advertising Opportunities SESSION/EVENT SPONSORSHIP ADVERTISE IN THE CONFERENCE PROGRAM RECEPTION SPONSOR Have your 4-color advertisement seen throughout the conference as attendees use the conference program • • • • • • • • • • • Listing on conference website as award & reception ceremony sponsor 1 full page ad in conference program Inclusive of all food & beverages 2 full-conference registrations (additional pre-conf. & full conf. may be purchased for staff, clients, etc). Onsite signage at reception and award ceremony Logo in sponsor section w/500 character statement Use of attendees list Insertion of 1 sponsor provided promotional item for each attendee’s conference bag Inclusion of 1 power-point ad slide rotating continuously throughout all conference breaks. Verbal acknowledgement and recognition during the opening and closing general sessions $15000 investment (one available) AUDIOVISUAL SPONSOR • • • • • • • • • Listing on conference website as audiovisual sponsor 1 full page ad in conference program 2 full-conference registrations (additional pre-conf. & full conf. may be purchased for staff, clients, etc). Logo in sponsor section w/500 character statement Use of attendees list Insertion of 1 sponsor provided promotional item for each attendee’s conference bag Inclusion of 1 power-point ad slide rotating continuously throughout all conference breaks. Verbal acknowledgement and recognition during the opening general session, keynote, and closing $15000 investment (one available) For additional information on any of the Sponsor or Exhibitor packages please call Stephanie KolakowskyHayner at 408.793.6446. Full page 81/2” x 11” (can bleed on four sides, 9” x 111/2”) $500 Inside front cover Full page, one available $850 Inside back cover Full page, one available $850 Outside back cover Full page, one available $1500 Half page 81/2” x 51/2” (can bleed on three sides, 9” x 53/4”) $300 Quarter page 41/4” x 51/2” (can bleed on two sides, 41/2” x 53/4) $200 Please supply only TIFF, EPS, or PDF print-ready files. Images should be 300 DPI or higher. For EPS files, all fonts should be outlined and all images should be provided. For PDF files, all fonts must be embedded. Deadline for receipt of advertising files is January 9, 2015. Please contact Jerry Wright at [email protected] or 408.793-6430 for additional information. CANCELLATION AND REFUND POLICY Exhibit, sponsorship, and advertising cancellations must be submitted in writing. Cancellations received by January 9, 2015 will be refunded less a $150 processing fee. There are no refunds for cancellations received after January 9, 2015. Hotel reservations must be cancelled directly through the Hotel, and are subject to Hotel Policies. Deposits are refundable if Santa Clara Marriott Hotel receives notice of cancellation at least 7 days prior to scheduled arrival. IMPORTANT DATES Early Bird Discount Expiration11/30/2014 Deadline for Logo Products12/15/2014 (Meeting bag, lanyard, flash drive) Deadline for Logo Inclusion in Program1/9/2015 Cancellation Deadline1/9/2015 8 — SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS One conference registration Two conference registrations Standard Exhibit Premium Exhibit Name on onsite signage Logo on onsite signage Non-profit Exhibit Standard Exhibit Premium Exhibit Silver Supporter ✓ Gold Supporter ✓ Platinum Supporter Volunteer T-shirt Materials Table Meeting Bag Insert WIFI Lanyard Meeting Bag Flash Drive Scholarship Lunch Presentation Award & Audiovisual Reception ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ Full page ad in program ✓ ✓ ✓ ✓ ✓ Rotating advertisement slide Special recognition at reception ✓ ✓ ✓ ✓ ✓ ✓ ✓ Logo in sponsor section Physical banner ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ Badge ribbon ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ Listing in program Use of the attendee list ✓ Logo on recognition slides Listing on conference website Inserted item in conference bag ✓ ✓ Verbal recognition at opening and closing ✓ Half page ad in program Logo on program cover SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS — 9 Attendee Schedule at a Glance Exhibitor Schedule at a Glance Thursday, February 5 7:00 - 8:00 AM Preconference 1 & 2 Registration 8:00 - 12:00 PM Preconference Sessions 1 & 2 12:00 - 1:00 PM Preconference 3 & 4 Registration 1:00 - 5:00 PM Preconference Sessions 3 & 4 2:00 - 5:00 PM Main Conference & Exhibitor Registration Thursday, February 5 2:00 PM - 5:00 PM Friday, February 6 7:00 - 8:00 AM Breakfast/Registration/Visit Exhibits 8:00 - 8:15 AM Welcome Announcements & Awards 8:15- 9:15 AM Keynote 9:20- 10:50 AM Plenary Presentation 1 10:50 - 11:20 AM Networking Break & Visit Exhibits 11:20 AM - 12:20 PM Breakout Sessions 1-4 12:20 - 1:20 PM Sponsored Networking Lunch 1:30 - 2:30 PM Breakout Sessions 5-8 2:30 - 3:00 PM Networking Break & Visit Exhibits 3:00- 3:45 PM Platform Sessions 1-12 3:55 - 4:55 PM Plenary Presentation 2 5:30 - 7:30 PM Reception with Exhibitors & Poster Session Saturday, February 7 7:00 - 8:00 AM 8:00 - 8:15 AM 8:15 - 9:15 AM 9:20 - 10:50 AM 10:50 - 11:20 AM 11:20 AM - 12:05 PM 12:05 - 1:05 PM 1:15 - 2:15 PM 2:15 - 2:45 PM 2:45 - 3:45 PM 3:55 - 4:55 PM 4:55 - 5:00 PM Breakfast/Registration/Visit Exhibits Morning Announcements & Awards Plenary Presentation 3 Plenary Presentation 4 Networking Break & Visit Exhibits Platform Presentations13-24 Sponsored Networking Lunch Breakout Sessions 9-12 Networking Break & Visit Exhibits Breakout Sessions 13-16 Plenary Presentation 5 Conference Wrap-up & Thank You 1 0 — SCVBIC | EXHIBITOR/SPONSOR PROSPECTUS Registration/Set-up Friday, February 6 7:00 - 8:00 AM Breakfast/Registration/Visit Exhibits 10:50 - 11:20 AM Networking Break & Visit Exhibits 2:30 - 3:00 PM Networking Break & Visit Exhibits 5:30 - 7:30 PM Poster Sessions/Reception with Exhibitors Saturday, February 7 7:00 - 8:00 AM 10:50 - 11:20 AM 2:15 - 2:45 PM 3:45 - 4:45 PM 4:55 - 5:00 PM Breakfast/Registration/Visit Exhibits Networking Break & Visit Exhibits Networking Break & Visit Exhibits Exhibitor break down Conference Wrap-up/Thank You IMPORTANT DATES Early Bird Discount Expiration11/30/2014 Deadline for Logo Inclusion in Program1/9/2015 Cancellation Deadline1/9/2015 Sponsorship & Exhibitor Form The 4th Annual Santa Clara Valley Brain Injury Conference: Building on the Legacy of Coma to Community Presented by the Santa Clara Valley Medical Center Rehabilitation Research Center Sponsor Information We would like to be a: Platinum Sponsor (Exhibit Fee: $10,000) Gold Sponsor (Exhibit Fee: $5,000) Silver Sponsor (Exhibit Fee $2,500) Exhibitor Information We wish to exhibit at the 4th Annual Santa Clara Valley Conference February 5 – February 7, 2015. Non-Profit Exhibit (Exhibit Fee: $800/$1000) Federal Tax Identification Number (TIN) Standard Exhibit (Exhibit Fee: $1,250/$1500) Other Sponsor ( Type: Fee Organization Name: Contact Person: Premium Exhibit (Exhibit Fee: $1,500/$2000) Organization Name: Contact Person: Address: City, State, Zip Code Contact Person Email Address: Address: City, State, Zip Code Contact Person Email Address: Contact Person Telephone Number: Brief Description of Product or Service Contact Person Telephone Number: If your level of sponsorship comes with registration: Brief Description of Product or Service Name 1 (Exactly as it is to appear on the badge) Name 2 (Exactly as it is to appear on the badge) The non-profit, standard and premium exhibit fee includes 1 full registration for the conference. A badge will be issued to the following representative/registrant: Name 1 (Exactly as it is to appear on the badge) ) Sponsorship & Exhibitor Form The 4th Annual Santa Clara Valley Brain Injury Conference Presented by the Santa Clara Valley Medical Center Rehabilitation Research Center Payment Information Please make checks payable to the VMC Foundation, c/o TBI Conference Fund Enclosed is a check for $_______________ Please charge my credit card for $____________ Card type: Visa MC Amex Card Number: ________________________________________ Expiration Date: ________________________________________ Security Code: ________________________________________ Cardholder’s Name: ________________________________________ Terms and Conditions: 1. Non-Profit exhibitor fee includes: one registration to the main conference, one six-foot table with drapery and chair in the conference hallway (not secure—must remove valuables nightly), all conference breaks, meals and the reception, use of the attendee list, listing in the conference program and on the conference website. 2. Standard exhibit space includes: one registration to the main conference, one six-foot table with drapery and chair in the conference hallway (not secure—must remove valuables nightly), all conference breaks, meals and the reception, use of the attendee list, listing in the conference program and on the conference website. 3. Premium exhibitor fee includes: one registration to the main conference, one six-foot table with drapery and chair within the exhibit/reception hall (secure area/locked nightly), electricity, all conference breaks, meals and the reception, use of the attendee list, listing in the conference program and on the conference website. 4. Space is limited, and will be reserved on a first-come, first-serve basis as payment is received. Billing Address: ________________________________________ Questions? City, State, Zip Code: ________________________________________ For sponsorship or exhibitor questions, please call Stephanie Kolakowsky-Hayner at 408.793.6446 or email to Stephanie [email protected] Phone: ________________________________________ Completed forms can be mailed to: SCVBIC Conference Attn: Stephanie Kolakowsky-Hayner c/o Rehabilitation Research Center 751 S. Bascom Avenue San Jose, CA 95128 or faxed to 408.793.6434 Terms, Conditions and Purposes of Exhibiting at a CME Program CME Activity: SANTA CLARA VALLEY BRAIN INJURY CONFERENCE The above company wishes to exhibit or sponsor at this CME activity. An exhibit fee or sponsorship fee in the amount of $______________________ will be used to provide unrestricted support for the CME Activity. 1. Statement of Purpose: This CME program is for scientific and educational purposes only and will not promote the company’s products, directly or indirectly. 2. Ancillary Promotional Activities: a. Arrangements for exhibits may neither influence planning nor interfere with the presentation of the educational activity; b. Commercial/promotional materials may not be displayed nor distributed in the same room immediately before, during, or immediately after the CME activity nor in any material disseminated as part of the program; c. Representatives of commercial supporters and exhibitors may attend the CME activity if they wish, but may not engage in sales activity in the room where the educational activity is held. 3. Objectivity & Balance: SCVMC CME Committee will make every effort to ensure that data regarding the company’s products (or competing products) are objectively selected and presented, with favorable and unfavorable information, and balanced discussion of prevailing information on the product(s) and/or alternative treatments. 4. Independence of VMC Foundation and CME planners in the use of Contributed Funds: No additional funds from the commercial company will be paid to the program director, faculty, or others Involved with the CME activity (additional honoraria, extra social events, activity refreshments/meals, etc.) No funds from the Commercial Interest will be used to reimburse or defray the costs of traveling, or other personal expenses of non-faculty healthcare professionals attending continuing medical education activities. 5. The Exhibitor/Supporter agrees to abide by all requirements of the ACCME Standards for Commercial Support of Continuing Medical Education and the Administrative Policies and Procedure Manual of SCVMC VMC # 154.02 regarding Standards for Commercial Support at SCVMC 6. Upon request, furnish the Commercial Interest and CME Committee with documentation detailing the receipt and expenditure of the Commercial Support. The SCVMC designated Course chair/ CME planner agrees that the Commercial Support will be used only for the support of SCVMC CME activities Approved by SCVMC CME Committee 2014 Company Representative (name): Title: Signature Date Signature Date VMC Foundation Executive Director or Designee (name):
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