IPAC Exhibitor Application – Integrative Providers Association

Exhibit at IPAC

IPAC Exhibitor Application

PLEASE FILL THIS FORM OUT TO BE CONSIDERED FOR EXHIBITING AND/OR PARTICIPATING IN THE IPAC CONFERENCE SERIES. DUE TO A VARIETY OF REASONS, INCLUDING ACCREDITATION, NOT ALL APPLICANTS QUALIFY TO PARTICIPATE. ALL APPLICANTS, SPONSORS, EXHIBITORS, PRODUCTS AND PROGRAMS ARE SUBJECT TO APPROVAL BY THE IPA EDUCATION COMMITTEE AND/OR THE UNIVERSITY OF NEVADA, RENO SCHOOL OF MEDICINE, OFFICE OF CONTINUING MEDICAL EDUCATION, PRIOR TO ACCEPTANCE OF SPONSORSHIP, REGARDLESS OF PAYMENT STATUS. ALL SALES ARE FINAL, REGARDLESS OF ACCEPTANCE.

IF YOU HAVE ANY QUESTIONS REGARDING ELIGIBILITY, PLEASE CONTACT THE IPA EDUCATION COMMITTEE AT: EDUCATION@IPA.EDUCATION . IF YOU HAVE ANY QUESTIONS REGARDING THE COMPLETION OF THIS FORM, CALL 1-888-587-6720 AND ENTER EXTENSION 744, AND SOMEONE WILL ASSIST YOU. THANK YOU FOR BEING PART OF THE IPAC CONFERENCE SERIES.

Select The Upcoming Event(s) You Are Interested in Reserving or Applying For: (Click All That Apply)(Required)

IPAC2023NV (Oct 6-8 '23 - Las Vegas, Nevada)

Teach1Serve10 Free-Clinic Day - Clinical Practicum Workshop (Oct 8 '23 - Las Vegas, Nevada)

IPAC2024TX (March 15-16 '24 - Dallas TX, Addison Airport)

Name(Required)

First Last

Title(Required)

Company Name(Required)

Website(Required)

Company Overview/Description (100 Words)(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Company Phone Number(Required)

Cell Phone/Text Number (You Must Authorize Text Messages)(Required)

Upload Company Logo(Required)

Max. file size: 12 GB.

Upload Company/Product Brochure(Required)

Max. file size: 12 GB.

Select Booth Type Here

Available Options and Add-Ons

Total

Credit Card

Card Details

Cardholder Name

PLEASE FILL THIS FORM OUT TO BE CONSIDERED FOR SPONSORSHIP, EXHIBITING AND/OR PARTICIPATING IN THE IPAC CONFERENCE SERIES. DUE TO A VARIETY OF REASONS, INCLUDING ACCREDITATION, NOT ALL APPLICANTS QUALIFY TO PARTICIPATE. ALL APPLICANTS, SPONSORS, EXHIBITORS, PRODUCTS AND PROGRAMS ARE SUBJECT TO APPROVAL BY THE IPA EDUCATION COMMITTEE AND/OR THE UNIVERSITY OF NEVADA, RENO SCHOOL OF MEDICINE, OFFICE OF CONTINUING MEDICAL EDUCATION, PRIOR TO ACCEPTANCE OF SPONSORSHIP, REGARDLESS OF PAYMENT STATUS. ALL SALES ARE FINAL, REGARDLESS OF ACCEPTANCE.

IF YOU HAVE ANY QUESTIONS REGARDING ELIGIBILITY, PLEASE CONTACT THE IPA EDUCATION COMMITTEE AT: EDUCATION@IPA.EDUCATION

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Exhibit at IPAC

Exhibit at an IPAC

IPAC Exhibitor Application

Select The Upcoming Event(s) You Are Interested in Reserving or Applying For: (Click All That Apply)(Required)

IPAC2023NV (Oct 6-8 ’23 – Las Vegas, Nevada)

Teach1Serve10 Free-Clinic Day – Clinical Practicum Workshop (Oct 8 ’23 – Las Vegas, Nevada)

IPAC2024TX (March 15-16 ’24 – Dallas TX, Addison Airport)

Name(Required)

First Last

Title(Required)

Company Name(Required)

Website(Required)

Company Overview/Description (100 Words)(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Company Phone Number(Required)

Cell Phone/Text Number (You Must Authorize Text Messages)(Required)

Upload Company Logo(Required)

Max. file size: 12 GB.

Upload Company/Product Brochure(Required)

Max. file size: 12 GB.

Select Booth Type Here

Available Options and Add-Ons

Total

Credit Card

Card Details

Cardholder Name

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