DEADLINE DATE is Friday, July 27, 2012.

Requests may not be accepted after this date due to limited space availability. Requests will be handled on a first-come, first-served basis.

• To request function space, simply fill out this form. To help you in planning your event, a list of available days and times for exhibitor functions are noted below and within the guidelines.
• All requests will be reviewed by the CNS. Approval of your request will be emailed to you. Contact information for the hotel and audio visual company will be included in your space assignment confirmation email.
• Note: Functions directed toward the Congress of Neurological Surgeons attendees may not be scheduled to conflict with the CNS program or exhibit hours. Please submit one form per event even if CNS hotel space is not required.

View Function Space Guidelines

Menu Options

Penalty will result in a loss of all priority points. The CNS Official Hotels will not accept any unapproved requests for space.

[*required fields]

PLEASE COMPLETE ONE REQUEST FOR EACH FUNCTION ROOM REQUIRED.

*Company:

*Contact First & Last Name:

*On-site Contact First & Last Name:

*Function Name:

*Address:

*City, State & Zip: ,

*Country:

*Telephone:

Fax:

*E-mail:

FUNCTION TYPE

(Please note: Function space is to be used only for non-educational activities. Companies wishing to hold educational courses must use the Satellite Symposium request form and guidelines.)

Staff Sales Meeting   Networking Event   Social Event/Entertainment

Other

*Exptected # of Attendees:

Physicians   Company Personnel Only   Other

FUNCTION DAY/DATE

Days and Times Available for Exhibitor Functions Saturday, October 6 All Day - limited to events for corporate sales staff. Sunday, October 7 All day until 3:00 PM – limited to events for corporate sales staff. After 8:00 PM Monday, October 8 Prior to, but ending no later than, 7:00 AM. After 5:00 PM. Tuesday, October 9 Prior to, but ending no later than, 7:00 AM. After 5:00 PM. Wednesday, October 10 Prior to, but ending no later than, 7:00 AM. After 3:30 PM. * Must keep booth staffed.

*Day/Date:  Select a Date Saturday, October 6 Sunday, October 7 Monday, October 8 Tuesday, October 9 Wednesday, October 10

*Start Time - End Time [ex: 6:00 AM - 9:00 PM]  -

Yes, Room Needed Early for Special Setup Time: [ex: 6:00 AM]

SET-UP REQUIRED

Set-Up Option 1: Select a Set-Up Option 1 Conference Style Hollow Square U-Shape Theater Classroom Rounds Cocktail Tables Set-Up Option 2: Select a Set-Up Option 2 Conference Style Hollow Square U-Shape Theater Classroom Rounds Cocktail Tables

Other (If other set-up is required, please indicate below)

ADDITIONAL SPECIFICATIONS (check all that apply)

Audio-Visual will be provided by the official CNS Audio-Visual company – Freeman AV. You will be billed separately for these services. Contact information will follow with space assignment.

Elevated Stage with Lectern/Head Table for (#) Standing Lectern Only Food and Beverage Required Audio Visual Required Other (specify)

CNS TERMS & APPROVAL

Approval and confirmation of your space request will be faxed to you from the CNS. After your request is approved, you may contact the hotel directly to finalize your arrangements. We agree to abide by the requirements, restrictions and obligations as outlined in the Rules & Regulations for Exhibitors at the CNS Annual Meeting.

Signature:   Title: