LBH TechBar Session Participation Request

Thanks for your interest in participating in the LifeBridge Health TechBar Session. Your requested session will be reviewed on a first come first serve basis and confirmed within 5 business days if accepted. Each session is restricted to one or two promotional attendee(s) ONLY due to space limitation. LBH staff will be on site to conduct the concurrent LBH session. (Fields with * are required)

Location: Sinai Hospital Physician Lounge (1st Floor) Address: 2401 W Belvedere Ave. Baltimore, MD 21215 Time: Monday - Friday 12 noon - 2 pm.

Company*

Promotional Company

First Name of Promotional Attendee*

Last Name of Promotional Attendee*

Job Title*

Business Email Address*

Mobile Phone*

Needed for entrance assistance into the Physician Lounge

First Name of Second Promotional Attendee

Last Name of Second Promotional Attendee

Job Title of Second Promotional Attendee

Name of Requestor

Only if different than Attendee

Session Date*

Purpose*

Please describe briefly the purpose or goal of your participation

Giveaway and/or Promotional Materials

Please specify giveaway(s) and/or promotional materials that you plan to bring to the session.

Giveaway 1*

Giveaway 2

Promotional Materials & Picture(s) of Giveaways for review ONLY & Business Card(s) of Promotional Attendee*

(Please bring your own for the session)

Drag and drop files here or

Comments/Questions

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