Endocrine Society Event Ancillary Meeting Request Form

The Endocrine Society welcomes groups to host activities in conjunction with our annual, signature events. All ancillary meeting requests must be approved by the Society. Please complete this form to request space to host an ancillary meeting at an upcoming Endocrine Society signature event, and a member of our team will be in touch with you. Should you need assistance, please contact info@endocrine.org.

Company/Organization Name*

Contact Name*

Title*

Street Address*

City*

State/Province*

Zip/Postal Code*

Country*

Email (required)*

Primary Phone*

Event in Conjunction With (choose one or more)*

Select

Meeting Start Date*

Meeting End Date*

Start Time-specify am/pm (required)*

End Time-specify am/pm (required)*

Anticipated Attendance*

Ancillary Meeting Highlights*

Please tell us more about your ancillary meeting. How does it support the Society's mission? Does it relate to work you have done or are doing with any committees or staff liaisons at the Society? Please include any other highlights that will help us better understand your ancillary meeting!

Delivery Format*

Select or enter value

Target Audience(s)*

Please select up to (3) professional roles that align to the target audience(s) your ancillary meeting is designed to serve.

Select

Global Applicability*

Please indicate whether your ancillary meeting is better suited to a US or global audience, or whether you are uncertain of the target audience geography at this time.

Select

Number of Meeting Rooms Requesting (up to 3)*

Select

Room Set-up*

You may choose the seating arrangement that you believe will best serve your audience. If necessary, provide additional details below. For examples of Room Sets use this link - https://bit.ly/2UuVMHb

Select

Preferred Room Set-up/Meeting Details

Please add any special details regarding your room setup or any unique meeting details.

Will your ancillary meeting require food and beverage?*

Select

Will your meeting require audio visual?*

Select

Will your meeting require Wifi?*

Select

Will you need ancillary meeting design support?*

For an additional fee, the Endocrine Society can provide partial or comprehensive design assistance for your ancillary meeting including business modeling, registration support, space planning, food and beverage or A/V planning, signage, and more. If you are interested in discussing these services further, let us know!

Select

Ancillary Meeting Hosting Fees*

I acknowledge that the Endocrine Society may assess fees for planning support services and/or room rental, audio/visual, food and beverage, and other resources associated with the production of this ancillary meeting and understand that I will have the opportunity to review and agree to fees before confirming this request

Send me a copy of my responses

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