Display Fee Request Form

DISPLAY REQUEST FORM

DATE OF PROGRAM: Saturday, March 1st, 2025
TITLE OF PROGRAM: 2025 NASOIE ANNUAL MEETING
LOCATION OF PROGRAM: Common Spirit Holy Cross Hospital Mountain Point 3000 Triumph Blvd., Lehi, UT 84043
DISPLAY SET-UP TIME: Anytime between 6:00 and 7:15 AM

COMPANY NAME:(Required)

NAME OF ON-SITE REPRESENTATIVE(S) (maximum of 2/company):(Required)

Email(Required)

Phone(Required)

TABLETOP DISPLAY FEE: $3,000.00

SPECIAL REQUIREMENTS (electricity, etc.):(Required)

Note: We will contact you regarding special requirement fees, if any. By signing and dating below, you agree to pay in full for the display fee.

Exhibitor Booth/Table exhibit(Required)

Price:

Payment Method(Required)

American Express

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

MAKE PAYMENT PAYABLE TO “NASOIE” and Mail Check to

Mail Check to:
The Thyroid Clinic
4465 South 900 East, Suite 200, Salt Lake City, UT, 84124
Or, pay through Paypal: memberregistration@nasoie.com
Or, pay through wire transfer: Please call us at 305-630-9414 for account details.

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Display Fee Request Form

DISPLAY REQUEST FORM

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