Immunize Georgia Conference

Making Every Connection Count

Join us for the 24th Annual Immunize Georgia Conference held at the Columbus Convention and Trade Center on THURSDAY, OCTOBER 26 to learn the latest recommendations and best practices in immunization services.

24th Annual Immunize Georgia Exhibitor Registration

CONTACT NAME *
CONTACT NAME
EXHIBITOR NAME 1 *
EXHIBITOR NAME 1
EXHIBITOR NAME 2 (If applicable)
EXHIBITOR NAME 2 (If applicable)
TITLES AND CREDENTIALS: *
Check all that apply (both exhibitor 1 and 2)
WE WORK IN (choose one): *
Please type out your full company name, as it will be listed on your nametag exactly as written below.
PHONE *
PHONE
DAY OF CONTACT PHONE *
DAY OF CONTACT PHONE
ADDRESS
ADDRESS
DO YOU NEED ELECTRICITY? *
Please note: There is an additional $25 fee for a power strip.
LUNCH FOR EXHIBITOR 1 *
If you have a food allergy or special needs accommodation, please email us in advance at immunizegeorgia@golin.com
LUNCH FOR EXHIBITOR 2
If you have a food allergy or special needs accommodation, please email us in advance at immunizegeorgia@golin.com
EXHIBITOR LEVELS *
Please choose ONE of the following exhibitor levels
HOW DID YOU HEAR ABOUT US? *
Check all that apply
By checking this box, I attest that the completed information is accurate.

In accordance with the policies of the Accreditation Council for Continuing Medical Education (ACCME) and the display policy of the Mercer University School of Medicine, by providing funds for this CME activity through a Display/Exhibit Fee, you agree to the following conditions:

  1. All exhibitors must be in a room or area separate from the educational activity and the exhibits must not interfere or in any way compete with the learning experience.
  2. Exhibitors shall have no control over:
  • Identification of CME needs;
  • Determination of educational objectives;
  • Selection and presentation of content;
  • Selection of all persons and organizations that will be in a position to control the content of the CME;
  • Selection of educational methods;
  • Evaluation of the activity.

Immunize Georgia | 470-419-8666 | ImmunizeGeorgia@golin.com