Company Name:____________________________________________
Contact Name:______________________________________________
Address:___________________________________________________
City:___________________________ State______ Zip____________
Phone:_________________________ Fax:_______________________
E-Mail____________________________________________________

All sponsorships include one exhibit booth in a location determined by sponsorship level, one draped 2' x 6' table, two chairs and a company identification sign. (Please note that electrical outlets and telephone lines are an additional cost as determined by the Marriott.)

Make checks payable to Connecticut Orthopaedic Society.

Payment should accompany this application and be mailed to:

CT Orthopedic Society
Susan Schaffman, Executive Director
26 Riggs Avenue
West Hartford, CT 06107

For additional information and questions, please call Susan Schaffman at (860) 561-5205, fax (860)561-5514 or email sasshops@aol.com. Thank you.