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Medtronic ENT Exhibit ONLY Request

NOTE:

Documentation
Medtronic ENT requires that the Request Form be complete and all supporting documents be submitted before review.

  • Scroll through this Request Form to understand the information and documents necessary for submission.
  • Complete and Submit the Form, making sure to attach all required supporting documentation.

Process

  1. The Medtronic ENT BCS Coordinator will be your point of contact for any questions you may have. You will be notified if your submission is incomplete.
  2. All requests will be reviewed by the Medtronic ENT Donations and Subsidy Committee.
  3. Medtronic ENT will notify you of our decision within 45 days of receiving a complete application. This time frame allows Medtronic ENT to carefully review each request.

Please Note: If you leave this form idle for a period of 1 hour or more, the form will timeout and any information entered will be lost and you will need to re-enter it.

* Required Information

Requestor Information

*Name:

*Position/Title:

*Primary Institution:

*Phone:

- -

Alternative Phone:

- -

Fax:

- -

*Email Address:

(Used for correspondence regarding the request.)
   

Event Information

*1.

Event Name:

*2.

Expected Physician Attendance:

*3.

Event Date:

/ / Show Calendar (Enter first day if multi-day event.)
or if multiple dates:

*4.

Please attach a list or schedule of exhibit sizes and available pricing, choose method:

Attach file (you will be prompted to upload from the next page.)

Fax. To submit attachment by fax see point of contact for more information.

Email. To submit attachment by email, see point of contact for more information.

*5.

Please attach an event brochure, choose method:

Attach file (you will be prompted to upload from the next page.)

Fax. To submit attachment by fax see point of contact for more information.

Email. To submit attachment by email, see point of contact for more information.

In order to Review and Submit your exhibit request click Continue.

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