Exhibit Application & Contract

Hilton Orlando Convention Center

Orlando, FL

Monday, October 3, 2022 - Wednesday, October 5, 2022

Exhibiting Company Information

Please complete all sections and provide information exactly as you would like it to appear in the official exhibitor directory and listings.

Asterisk * notes a required field.

Company Name*

Legal name for contractual and invoicing purposes

Exhibiting Company Name

As you wish it to appear on customer facing materials (ex: Exhibit Hall floorplan, conference mobile app, etc.)

Company Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Company Website*

Company Email*

Company Phone Number*

Primary Sales Contact/Authorized Contract Signer: *

First Name

Last Name

Suffix (optional)

Primary Sales Contact Title*

Primary Sales Contact Email Address*

Primary Sales Contact Phone Number *

Is the Primary Contact/Authorized Contract Signer also the Exhibit Booth Logistics Contact who should receive the invoice, exhibitor newsletters, Exhibitor Services Manual, registration/housing information etc.?*

Yes No

Logistics/Booth Contact Name*

First Name

Last Name

Suffix (optional)

Logistics/Booth Contact Email Address*

Logistics/Booth Contact Phone Number*

Does your company have a specific Marketing Contact for Year Round Advertising and Annual Conference Marketing Opportunities?*

Primary Contact/Authorized Contract Signer listed above. Exhibit Booth Logistics Contact listed above. Please send information to a Marketing Contact. My company is not interested in advertising/marketing opportunities.

Marketing Contact Name*

First Name

Last Name

Suffix (optional)

Marketing Contact Email Address*

Marketing Contact Phone Number *

Exhibit Package Information

Each booth location is a 10' x 10' (100 sq. ft.) inline space.

Corner location(s) are an addition $250 fee.

AHE does not permit endcaps when selecting space.

*In order for contracts to be processed, companies MUST select one of the booth packages listed below.

Each Exhibiting Company will receive two (2) complementary Full Conference Badge regardless of booth size.

Standard Exhibit Package

• 10'x10' Booth Space • (3) Three Exhibit Hall Only Badges • (2) Full Conference Exhibitor Badges • Company Listing in Online Directory and Mobile App • Post Show Attendee Mailing Labels

$ 3,100.00

Quantity:

Premium Exhibit Package

• 10'x10' Booth Space • (3) Three Exhibit Hall Only Badges • (2) Full Conference Exhibitor Badges • Company Listing in Online Directory and Mobile App • Post Show Attendee Mailing Labels • Search for Solutions (formerly Passport to Prizes) • Registration Bag Insert

$ 3,800.00

Quantity:

Corner Fee

Each corner location(s) are an additional $250 fee.

$ 250.00

Quantity:

Additional 10'x10' Exhibit Space

If looking for an exhibit space larger than the standard 10'x10' exhibit space, please note your company's preferred booth size here. Additional 10'x10' spaces are $3,100 each.

$ 3,100.00

Quantity:

Names of companies you do not want to be next to or directly across from:

Names of companies you want to be near:

Comments

Company Logo

No File Chosen

File uploads may not work on some mobile devices.

Please upload a high resolution .jpg or .png file.

Payment Method & Information

Exhibitor must remit payment within 30 days of receipt of their invoice. Full payment must be received on or before Friday, September 16, 2022, regardless of Contract submission date.

AHE will issue invoices as applicable. Credit card payments can be made online using American Express, MasterCard or Visa. Checks must be payable to AHE and can be remitted to the following address via the U.S. Postal Service:

AHE

75 Remittance Drive, Suite 1272

Chicago, IL 60675

Alternatively, Exhibitor may remit via overnight currier (e.g., FedEx) to the following address:

AHE - AHE Suite #1272

5505 North Cumberland Avenue, Suite 307

Chicago, IL 60656-1471

Exhibitors who choose to pay by ACH/wire will require the following information:

Bank: Northern Trust

Bank Location: Chicago, IL

ABA: 071000152

SWIFT: CNORUS44 (for foreign transfers)

Account Name: American Hospital Association

Account #: 78697

The tax ID number is 36-0726140. A W-9 form is available by request. Exhibitors can email Pat Brayley at pbrayley@smithbucklin.com with payments questions or to request a W-9.

Does your organization have a specific Accounts Payable or Agency contact that invoice should be sent to?*

Yes No, please send invoice to primary contact listed.

Name of Agency (if applicable)

Accounts Payable/ Agency Contact Information *

First Name

Last Name

Email*

Phone*

Agency Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Indicate your payment method (choose one):*

ACH/Wire - Send me ACH/wire instructions to remit my payment. Check – I plan to send a check to the address listed above within 30 days of receipt of my invoice. Credit Card – Send me an invoice with a secure link to pay by credit card.

Is a Purchase Order (PO) Required for payment? *

Yes No

Please list Purchase Order (PO) Number here. *

Please note any additional billing instructions here.

EXCHANGE AHE Conference & Solutions Center

Privacy Policy Consent

NOTE: THE FOLLOWING CONSENT MUST BE REVIEWED AND ACCEPTED BY THE PRIMARY CONTACT/AUTHORIZED CONTRACT SIGNER LISTED ON THIS CONTRACT BEFORE YOUR CONTRACT WILL BE PROCESSED.

By clicking on "Acknowledge & Submit Contract" below, you are providing AHE with your express consent for AHE to use your personal data as follows:

AHE uses the data your provide to inform you about the 2022 AHE Exchange, and AHE events, products or news that may be of interest to you, and such other purposes which are within the scope of AHE's exempt purpose and mission
AHE shared the data your provide with third party vendors in order to process your registration, to make you aware of goods and services you may be interested in, to perform analytics on behalf of AHE, in connection with the 2022 AHE Exchange, and for such other purposes as AHE may approve from time to time

For more information regarding your person data right, please review the AHA Privacy Policy.

I acknowledge that I have read and submit my agreement to the AHA Privacy Policy

Acceptance & Signature

By submitting this Application & Contract, my company agrees to abide by all terms as printed in the AHE Exchange Exhibitor Contract Conditions/Rules & Regulations for exhibit space. I have the authority to execute this agreement on behalf of my company and agree not to challenge the validity of this electronically signed contract.

2022 AHE Exchange Exhibitor Contract Conditions/Rules & Regulations

Rules and Regulations Acceptance *

I acknowledge that I have read and submit my agreement to the Exhibitor Contract Conditions/Rules & Regulations Authorize Signature.

Authorize Signature*

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Use your mouse or finger to draw your signature above.

Authorize Signer's Name*

First Name

Last Name

Suffix (optional)

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