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EXHIBIT 2011 Mid Year Symposium

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					2011 Mid-Year Symposium One-Day Event
Grand Hotel Baglioni, Florence, ITALY
> APRIL 9, 2011
              SPONSORSHIP & EXHIBIT                         Opportunities

                                      PLATINuM LEvEL - $4,000
Benefits:   Acknowledgement of sponsorship in opening remarks; Listing in registration materials; High profile
            signage; Organization/company name featured on pharmacoepi.org; Sponsor ribbons for staff attending
            the meeting; 3-complimentary registrations to symposium; and complimentary tabletop exhibit space
            during symposium.


                                         GOLD LEvEL - $2,000
Benefits:   Acknowledgement of sponsorship in opening remarks; Listing in registration materials; High profile
            signage; Organization/company name featured on pharmacoepi.org; Sponsor ribbons for staff attending
            the meeting; 2-complimentary registrations to symposium; and complimentary tabletop exhibit space
            during symposium.


                                        SILvER LEvEL - $1,000
Benefits:   Acknowledgement of sponsorship in opening remarks; Listing in registration materials; High profile sig-
            nage; Organization/company name featured on pharmacoepi.org; Sponsor ribbons for staff attending the
            meeting; 1-complimentary registration to symposium; and complimentary tabletop exhibit space during
            symposium.


                                         BRONzE LEvEL - $500
Benefits:   Listing in registration materials; High profile signage; Organization/company name featured on
            pharmacoepi.org; and sponsor ribbons for staff attending the meeting.




                                                                   EXHIBIT
                                                                      Tabletop Exhibit Space Only
                                                                    $750 (Industry/Service Provider)
                                                                     $350 (Government /Academic)
                                                               Benefits: One tabletop exhibit during exhibition;
                                                            Listing in registration materials; High profile signage;
                                                                Company name features on pharmacoepi.org;
                                                              exhibitor ribbons for staff attending the meeting.
    2011 MID-YEAR SYMPOSIuM                                                  Application
                                         Florence, ITALY        APRIL 9, 2011


PLEASE CHECk (X) LEvEL SELECTED: (all Prices in Us Dollars)
     SPOnSORShIP:                                             tABLetOP eXhIBIt (only)
        o		Platinum Level     $ 4,000                              o		Industry/Service Provider            $ 750
        o		Gold Level         $ 2,000                              o		Government/Academic                  $ 350
        o		Silver Level       $ 1,000                              o		Wire Transfer Fee                    $ 85
        o		Bronze Level       $ 500
        o		Wire Transfer Fee $       85

Please Print Clearly
Organization/Company Name: ________________________________________________________________
Representative: ___________________________________________________________________________
Address: ________________________________________________________________________________
City/State/Postal Code: _________________________             Country: ___________________________________
Phone: (_______) ____________-_____________                   Fax:   (_______) ____________-_______________
Email: __________________________________________________________________________________


PAyment methOd:
	       o		Please send me an invoice               o		Check enclosed   (PayaBle to “isPe” in Us Dollars)

        o		Send wire information. Additional charge for wire is $85
        o		Credit card (check one). ____ American Express         ____ vISA        ____ MasterCard

        Total Amount to be Charged: $ ________________________________________


        Card number: ______________________________________________________________________
        Name on Card: _____________________________________________________________________
        Expiration: __________/___________ Security Code: ______________________________________
                       Month          Year


MAIl, fAX Or EMAIl cOMPlETEd APPlIcATIOn TO:
    Mail: ISPE - 2011 SPONSORSHIP            5272 River Road. Suite 630 Bethesda, MD uSA 20816
    Fax: 301-656-0989              Email: ajerdonek@paimgmt.com                 Phone: 301-718-6500
    federal tax identification number: 41-1688677

				
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