Exhibitor Registration without Paying Exhibitor Comprehensive 2021 Pay Later Begin HereExhibit space will be assigned on a first-come, first-served basis, according to the date the contract and deposit are received. Whenever possible, space will be assigned according to the Exhibitor's request; however, final arrangements will be determined by MAFP staff. The preferences given for booth location are for guidance and not guaranteed.Company NameTo be used for booth sign. Please put EXACTLY as you wish it to appear in print. Limited to 40 characters. The abbreviations Inc., Co., Corp. will be used. First Time Attendee? YES NO How did you hear about us? Official Exhibit RepresentativeName First Last Title Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Mobile PhoneEmail* Event SelectionYou may select the PACKAGE below to secure a booth for all 3 events, or you may choose individual event(s) below.Exhibit Package for 2021 (all 3 events)Includes all 3 exhibit opportunities for 2021 Price: $2,500.00 Quantity: Spring Conference Exhibit BoothApril 24-25, 2021, Hilton Hotel in Jackson MS Price: $700.00 Quantity: Annual Meeting Exhibit BoothJuly 17-21, 2021, at Baytowne Conf. Center in Sandestin, FL Price: $1,700.00 Quantity: Fall Conference Exhibit BoothOctober 8-10, 2021 at The Lodge, Gulf Shores, AL Price: $700.00 Quantity: Exhibitor Names and CitiesMAFP will provide 5 complimentary personnel nametags. Each additional nametag is $25.Attendee 1: Name, City, State Attendee 2: Name, City, State Attendee 3: Name, City, State Attendee 4: Name, City, State Attendee 5: Name, City, State Attendee 6: Name, City, StateUp to 5 attendees are included in the cost of the exhibit. Each attendee after 5 costs $25 each. Attendee 7: Name, City, StateUp to 5 attendees are included in the cost of the exhibit. Each attendee after 5 costs $25 each. Attendee 8: Name, City, StateUp to 5 attendees are included in the cost of the exhibit. Each attendee after 5 costs $25 each. Attendee 9: Name, City, StateUp to 5 attendees are included in the cost of the exhibit. Each attendee after 5 costs $25 each. Attendee 10: Name, City, StateUp to 5 attendees are included in the cost of the exhibit. Each attendee after 5 costs $25 each. Cancellation PolicyIF MAFP cancels the meeting, all monies will be refunded to paid exhibitors. If cancellation by the exhibitor becomes necessary, MAFP will refund $250 of exhibit fee ONLY IF WRITTEN PRIOR to May 31, 2021. If a space is cancelled after May 31, 2020, full payment for space will still be due. If assigned space is not paid for in full by May 31, 2020 it may be reassigned to another exhibitor at the option of the MAFP Education Committee without refund of deposit. Discounts and exhibit space cannot be given to organizations providing unrestricted grant money to the CME program. It is understood that the exhibiting company and all of its representatives associated with the MAFP Annual Meeting will abide by all Rules, Regulations and Ethics of the MAFP as set forth in the Prospectus and Invitation to Exhibit, and that it is the responsibility of the person signing this Contract to inform his/her representatives of the MAFP Rules, Regulations and Ethics. Agreement* I have read and agree to pay exhibit fee and abide by information in this Prospectus and Invitation to Exhibit on regulations governing exhibitors. PaymentPlease make sure you have read the application. Space will be charged in accordance with the application. No space will be assigned without a deposit of 50% of the total cost. Note: No booth assignments will be made until these conditions are met. No company will be allowed to set up their exhibit until full booth fee payment has been received by the MAFP or firm, formal arrangements have been made in advance with the MAFP.Total Due $0.00 NameThis field is for validation purposes and should be left unchanged.
