EXHIBIT REGISTRATION

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EXHIBIT REGISTRATION Fax or email completed form to Tamara Parris, Fax No. 301-565-3390 or email tparris@danyainstitute.org by September 1, 2015 to be included in the printed conference program. Exhibit registrations after this date are welcome, but may not be included in the conference program. If paying by check please send exhibit registration form and fee to: National Conference on Tackling Tobacco Use in Vulnerable Populations (NCTVP) The Danya Institute 8737 Colesville Road, Suite 300 Silver Spring, MD 20910-3921 WHO SHOULD EXHIBIT Exhibits are open to federal and state agencies, public and private corporations and foundations, behavioral health, public health, primary care, community prevention associations. Exhibitors should be interested and engaged in tobacco control and cessation. WHO WILL ATTEND The conference is attended by 200 healthcare professionals from leading tobacco cessations, behavioral health, primary care, public health, community prevention, federally qualified health centers, military, policy-makers, advocates, consumers, and peers in recovery. CONFERENCE LOCATION Bethesda North Marriott Hotel & Conference Center 5701 Marinelli Road Bethesda, MD 20852 Tel. 1-301-822-9200 EXHIBIT FEES For-profit organizations: $500 per exhibit Non-profit organizations: $350 per exhibit Federal Government Agency: Free EXHIBIT SET-UP

Monday, October 5, 2015, 6:00 am to 7:30 am If you wish to set up the evening before (Sunday, October 4, 2015) please let us know so we can make those arrangements with the hotel. We suggest that you only set up your exhibit booth beforehand and wait until Monday morning to put your materials out on the table. EXHIBIT HOURS Monday, October 4, 2015 7:30 am to 5:00 pm. Tuesday, October 5, 2015 7:30 am to 2:00 pm. EXHIBIT SHUT-DOWN Tuesday, October 5, 2015 conference ends at 3:00 pm. Exhibits must be dismantled immediately following the 3:00 pm closing of the conference on Tuesday, October 5, 2015. All exhibit materials must be removed by 5:00 pm. EXHIBIT SPACE ASSIGNMENTS Conference staff will assign exhibit space on a first-come, first-served basis, after registration and payment is received. CONFIRMATION Each paid exhibitor will receive an e-mail confirmation prior to the conference. Please submit an e-mail address on the registration form to receive exhibitor updates from conference staff. STANDARD EXHIBIT BENEFITS One, 30 x 6' draped table Organization identification sign tent card Two chairs One paid attendee registration (includes badge plus materials) Organization listing in the conference program and on the conference website EXHIBIT CONTENT Exhibits and all associated displays, demonstrations and promotional activities must be suitable and support the overall conference goal and objectives. ADDITIONAL SERVICES OR EQUIPMENT Additional services or equipment (e.g., electricity, telephone service, lighting, furniture, Internet access) are not covered by the exhibit registration fee. If your exhibit requires services or equipment other than what already exists, please indicate this on the registration form. There will be additional fees for electricity and internet connection. All requests for these services must be done in advance of arrival at the exhibit site. We will not be responsible for making these arrangements on site.

SHIPPING AND RECEIVING Packages may be delivered directly to the hotel for arrival no earlier than Tuesday, September 29, 2015. To ensure that materials are sorted and delivered properly, please include the following information on all packages: Bethesda North Marriott Hotel & Conference Center 5701 Marinelli Road Bethesda, MD 20852 Event Manager for Tobacco Conference No. of box ( (i.e. 1 of 2, 2 of 2, etc.). There is a fee for shipping and handling of materials. Your confirmation will include payment instructions and onsite contact information. SECURITY Security of exhibits and/or exhibit materials is the sole responsibility of the exhibitor. No uniformed or non-uniformed security will be provided. SUBLETTING The subletting, assignment, or apportionment of the whole or any part of the exhibitor's space, by an exhibitor, is prohibited. INSURANCE It shall be the responsibility of each exhibitor to maintain insurance coverage against injury to persons or damage to or loss of property or to meet its obligations under this agreement, in such amounts as the exhibitor shall deem adequate. CARE OF BUILDING Exhibitors will be held responsible for any damage done to the building, equipment, or decorations by them or their employees. Nothing shall be posted, nailed or screwed or otherwise attached to columns, walls, floors or other parts of the building or furniture. Distribution of promotional gummed stickers or labels is strictly prohibited. Anything in connection therewith necessary or proper for the protection of the building, equipment or furniture will be at the expense of the exhibitor.

INDEMNIFICATION The exhibitor assumes the entire responsibility and liability for losses, damages, and claims arising out of exhibitor's activities on the hotel premises and will indemnify, defend, and hold harmless the National Conference on Tobacco/Danya Institute, Inc. and the Hotel, its owner, its management company, as well as their respective agents, servants, and employees from any and all such losses, damages, and claims. CANCELLATION/REFUNDS Send cancellation/refund requests to Tamara Parris by August 17, 2015. Refund requests received prior to this date will be returned less a $100 processing fee. The National Conference on Tackling Tobacco Use in Vulnerable Populations will not refund exhibit registration fees for any reason after August 17, 2015.

Exhibitor Registration Form Please print or type all information requested and make a photocopy for your records. Organization Name (Exactly as it will appear on printed materials and booth signage) Street Address City/State/Zip Telephone Email Fax Website Contact Information: Contact Person/Title Name of person who will be onsite exhibiting (this will be used for the name badge) Company/Organization (complete if different from above information) Street Address City, State, Zip

Telephone Fax Email Exhibitor Package includes a 30 x 6 with pipe and drape; Two chairs; Listing in the Conference Program (must be registered by September 1st) EXHIBIT FEES For-profit organizations: $500 per exhibit Non-profit organizations: $350 per exhibit Federal Government Agency: Free Number of Booths Requested: Total Amount: Do you require electrical or internet hookup? yes no INTERNET DATA PER DAY QTY DAYS TOTAL Wired High Speed Internet Access $200.00 Wireless High Speed Internet $150.00 POWER: SINGLE PHASE PER DAY QTY DAYS TOTAL 20A 120V $70.00 30A 120V $90.00 Power Strip or Extension Cord $40.00 PAYMENT METHOD: Check enclosed made payable to The Danya Institute in the amount of $ (add electricity and/or internet fee to registration fee). Bill credit card $. (add electricity and/or internet fee to registration fee). We accept Visa/MasterCard/American Express (Circle one) Credit Card No. Exp. Date CSC number From the back of card Print Cardholder s Name Signature of Cardholder

Other sponsorship opportunities are still available. We can customize to meet your organizational needs. Please call or email to get further information (240-645-1145 or tparris@danyainstitute.org). Sponsor a break Sponsor a scholarship Sponsor a dinner Sponsor a luncheon The Danya Institute/Central East ATTC 8737 Colesville Road, Suite 300 Silver Spring, MD 20910-3921 Tel. 240-645-1145 Fax 301-565-3390