44th Annual District VIII Conference on Neonatal-Perinatal Medicine Exhibitor/Sponsor LOA

This virtual event is scheduled for June 16-18, 2021. We offer five levels of sponsorship: Platinum $10,000 Gold $5,000 Silver $2,500 Bronze $1,000 Non-profit $100 Credit cards, checks and UNM Internal PRs are accepted for payment. We cannot accept purchase orders. Checks should be made payable to UNM-CPL and mailed to: University of New Mexico, Office for Continuous Professional Learning MSC09 5370 1 University of New Mexico Albuquerque, NM 87131. **PLEASE NOTE: exhibitor fee is due no later than 30 days post-conference.** Notice of cancellation MUST be submitted in writing to UNM CPL at least TWO WEEKS prior to the conference (by June 2) or the full fee will be billed to the organization named above. Exhibit fees cannot be refunded if cancellation is received less than two weeks prior to the conference. The UNM CPL Tax ID# is: 85-6000642.

EXHIBIT/SPONSOR INFORMATION

Organization/Company Name*

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Website

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BOOTH / SPONSOR CONTACT PERSON

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Contact Person

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BOOTH REPRESENTATIVE(S)

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# of Booth Representatives

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Booth Representative #1 Name

Booth Representative #1 Title

Booth Representative #1 Phone

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Booth Representative #2 Name

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Booth Representative #3 Name

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Booth Representative #4 Name

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EXHIBITOR/SPONSOR OPPORTUNITIES

**PLEASE NOTE: exhibitor fee is due no later than 30 days post-conference.** Notice of cancellation MUST be submitted in writing to UNM CPL at least TWO WEEKS prior to the conference (by March 27) or the full fee will be billed to the organization named above. Exhibit fees cannot be refunded if cancellation is received less than two weeks prior to the conference.

Exhibitor Opportunities*

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CONDITIONS

1. Statement of Purpose: program is for scientific and educational purposes only and will not promote the company's products, directly or indirectly. 2. Control of Content & Selection of Presenters & Moderators: UNM CPL is responsible for control of content and selection of presenters and moderators. The Company agrees not to direct the content of the program. The Company or its agents will respond only to UNM CPL-initiated requests for suggestions of presenters or sources of possible presenters. The Company will suggest more than one name (if possible); will provide speaker qualifications; will disclose financial or other relationships between Company and speaker, and will provide his information in writing. UNM CPL will record role of Company, or its agents, in suggesting presenter(s); will seek suggestions from other sources, and will make selection of presenter(s) based on balance and independence. 3. Disclosure of Financial Relationships: UNM CPL will ensure meaningful disclosure to the audience, at the time of the program, of (a) Company funding, and (b) any significant relationship between the UNM CPL and the Company (e.g. grant recipient) or between individual speakers or moderators and the company. 4. Involvement in Content: there will be no "scripting", emphasis, or direction of content by the Company or its agents. 5. Ancillary Promotional Activities: no promotional activities will be permitted in the same room or obligate path as the educational activity. No product advertisements will be permitted in the program room. 6. Objectivity & Balance: UNM CPL will make every effort to ensure that data regarding the company's products (or competing products) are objectively selected and presented, with favorable and unfavorable information and balanced discussion of prevailing information on the product(s) and/or alternative treatments. 7. Limitations of Data: UNM CPL will ensure, to the extent possible, meaningful disclosure of limitations on data, e.g., ongoing research, interim analyses, preliminary data, or unsupported opinion. 8. Discussion of Unapproved Uses: UNM CPL will require that presenters disclose when a product is not approved in the United States for the use under discussion. 9. Opportunities for Debate: UNM CPL will ensure meaningful opportunities for questioning or scientific debate. 10. Independence of UNM CPL in the use of Contributed Funds: a. funds should be in the form of a sponsorship made payable to UNM CPL. b. all other support associated with this CME activity (e.g., distributing brochures, preparing slides, etc.) must be given with the full knowledge and approval of UNM CPL. c. no other funds from the commercial company will be paid to the program director, faculty, or others involved with the CME activity (additional honoraria, extra social events, etc.). 11. Per ACCME, the accredited provider (UNM CPL) must not share the names or contact information of learners with any ineligible company or its agents without the explicit consent of the individual learner. The Commercial Supporter agrees to abide by all requirements of the ACCME Standards for Commercial Support of Continuing Medical Education (appended). The Accredited Sponsor agrees to: 1) abide by the ACCME Standards for Commercial Support of Continuing Medical Education; 2) acknowledge educational support from the commercial company in program brochures, syllabi, and other program materials, and 3) upon request, furnish the commercial supporter a report concerning the expenditure of the funds provided.

By electronically signing this document, I agree to the above conditions.

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Date*

PAYMENT OPTIONS

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Once you have submitted this form you will be automatically directed to our TouchNet payment portal. Please enter your payment information to complete your exhibitor registration. If you do not complete the payment page your exhibitor registration is incomplete. You will receive an email from TouchNet with your payment receipt once payment is received.

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File Upload*

*Your exhibitor registration is not complete until we have received your payment method. If you are paying by check, a copy of the check MUST be uploaded here. Checks MUST be received by UNM CPL within 5 business days of completing this registration site. Please make checks payable to: UNM CPL 1 University of New Mexico MSC09 5370 Albuquerque, NM 87131-0001 If you are paying by UNM PR, a copy of the PR MUST be uploaded here. *This is a required field and you will not be able to finish this form unless you upload something. If you are unable to upload the necessary information listed above, please contact us at HSC-CPL@salud.unm.edu or 505-272-3942 for assistance.

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𝗢𝗻𝗰𝗲 𝘆𝗼𝘂 𝗵𝗮𝘃𝗲 𝘀𝘂𝗯𝗺𝗶𝘁𝘁𝗲𝗱 𝘁𝗵𝗶𝘀 𝗳𝗼𝗿𝗺 𝘆𝗼𝘂 𝘄𝗶𝗹𝗹 𝗯𝗲 𝗮𝘂𝘁𝗼𝗺𝗮𝘁𝗶𝗰𝗮𝗹𝗹𝘆 𝗱𝗶𝗿𝗲𝗰𝘁𝗲𝗱 𝘁𝗼 𝗼𝘂𝗿 𝗧𝗼𝘂𝗰𝗵𝗡𝗲𝘁 𝗽𝗮𝘆𝗺𝗲𝗻𝘁 𝗽𝗼𝗿𝘁𝗮𝗹. If you are paying with a Credit Card you MUST complete your payment in this portal. If you are not paying with a credit card your form is complete after you hit the submit button below and you can exit the TouchNet payment Portal you are redirected to. *𝒀𝒐𝒖𝒓 𝒆𝒙𝒉𝒊𝒃𝒊𝒕𝒐𝒓 𝒓𝒆𝒈𝒊𝒔𝒕𝒓𝒂𝒕𝒊𝒐𝒏 𝒊𝒔 𝒏𝒐𝒕 𝒄𝒐𝒎𝒑𝒍𝒆𝒕𝒆 𝒖𝒏𝒕𝒊𝒍 𝒘𝒆 𝒉𝒂𝒗𝒆 𝒓𝒆𝒄𝒆𝒊𝒗𝒆𝒅 𝒚𝒐𝒖𝒓 𝒑𝒂𝒚𝒎𝒆𝒏𝒕 𝒎𝒆𝒕𝒉𝒐𝒅.

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