FHCA Exhibitor Registration FHCA Exhibitor Registration 2020 FHCA is following guidance from the Florida Department of Health and Centers for Disease Control and Prevention in response to COVID-19. Our goal is always to keep our event attendees healthy and safe. At this time, FHCA's Annual Conference & Trade Show is still scheduled as planned; however, COVID-19 is an emerging issue. We encourage you to check this website often should any schedule changes be made. July 12-16, 2020 *Trade show July 13-14 The Diplomat Beach Resort, Hollywood, FL Exhibitor Contact Information Please enter your information as it should appear on all signs and printed materials.Company Name*Primary Contact* First Last 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*Primary Email* Website Courtesy Contact (to receive logistical communications) First Last TitlePhoneEmail Use our description from the 2019 show* Yes No OR provide a products/services description (25 WORDS OR LESS) for printed materials.**Descriptions longer than 25 words are subject to being shortened. ** Please Read and Agree - Due to security and sales tax implications, no firm or organization sponsoring the FHCA Annual Conference or serving as an exhibitor is permitted to engage in direct sales (cash, check, or credit card) activity within the exhibit area or contracted conference space. By selecting this, you agree to accept and abide by this policy.* I Agree Booth Details and PricingSelect either Member or Nonmember Booth Rate. **$100 discount will be applied for each additional booth after the first booth.** Member rate will only be honored if 2020 Associate Member dues have been paid. Associate Member dues start at $650. To pay 2020 member dues, click here. To check the status of your company's membership, please contact Tammy Elliott at email@example.com or call (850)224-3907. Sign up to become a member for only $650 and save $1,400 off your booth fee! Booth: Member Rate (Before May 22)1st Booth - $1,1002nd Booth: Member Rate (Before May 22) * if needed2nd Booth - $1,000NoneDiscount for 2nd Booth Price: -$100.00 3rd Booth: Member Rate (Before May 22) * if needed3rd Booth - $1,000NoneDiscount for 3rd Booth Price: -$100.00 Booth: Nonmember Rate (Before May 22)1st Booth - $2,5002nd Booth: Nonmember Rate (Before May 22)2nd Booth - $2,400NoneDiscount Price: -$100.00 3rd Booth: Non-member Rate (Before May 22)3rd Booth - $2,400NoneDiscount Price: -$100.00 Choose your BoothTo view the latest floor plan, click hereReminder - A sponsorship booth (OS, SC, SS) requires the purchase of a sponsorship in addition to the cost of the booth. Note: Bronze, Silver and Gold Sponsors are eligible for Special Sponsor (SS) Booths.* I have read the reminder First Choice*10110310410510610710911111711811912012112320220320420520620821621721821922030640391910211022102310241025111911221203120712091216121712181219122012211302130313041305130613071308131613181319132013211323Second Choice*10110310410510610710911111711811912012112320220320420520620821621721821922030640391910211022102310241025111911221203120712091216121712181219122012211302130313041305130613071308131613181319132013211323Third Choice*10110310410510610710911111711811912012112320220320420520620821621721821922030640391910211022102310241025111911221203120712091216121712181219122012211302130313041305130613071308131613181319132013211323Different Levels of Participation (sponsorships)Standard (no sponsorship) Price: $0.00 Quantity: OS Sponsorship Price: $1,500.00 Quantity: Bronze Sponsorship Price: $3,500.00 Quantity: Silver Sponsorship Price: $5,500.00 Quantity: Gold Sponsorship Price: $7,500.00 Quantity: Please list any competing companies that you would like to NOT be near.Prize Yes, we will supply a prize No, we will not supply a prize Provide a prize for attendees to win, right from your booth! A list of exhibitors and prizes will be published in conference materials. Prize information must be supplied to FHCA on or before Friday, June 7, 2019 to meet publication deadline. Attendees must claim their prizes from exhibitors; exhibitors are responsible for delivering unclaimed prizes to winners. If yes, what prize will you supply?Lead Retrieval Lead Retrieval allows exhibitors to engage with attendees in a permission-based, interactive format through their individual smartphone or tablet device. Lead Retrieval also allows exhibitors to keep track of attendees who have checked into their booth, by scanning their badges to collect their information and to message attendees directly through the app and take notes on their conversation.Lead Retrieval*Please SelectEvent Only - $150Year Round (Amazing Value!) - $300Advertising DetailsFull color ad space is available for exhibitors in our Conference Program. Attendees refer to the Program all during Conference when checking for details on seminars and other events.Full Page Price: $1,000.00 Quantity: Half Page Price: $750.00 Quantity: Quarter Page Price: $500.00 Quantity: Exhibitor Registration Total $0.00 TotalPlease read the following information carefully. This Contract is invalid unless the below terms are accepted.* Agree As the authorized representative of my company, I have read the entire terms of the Contract and the rules and regulations contained in the FHCA Annual Conference Exhibitor Prospectus, which are incorporated herein by reference, and agree to accept and abide by all of this Contract and the rules and regulations outlined. Please check the box below to continue. Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged.