"*" indicates required fields NameThis field is for validation purposes and should be left unchanged.Company Name*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCĂ´te d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRĂ©unionSaint BarthĂ©lemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTĂĽrkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweĂ…land Islands Country Contact Name* First Last Contact Email* Contact PhoneLogoMax. file size: 64 MB. Preferred formats: jpg or png. If you cannot provide your logo now, you may email it separately to erinv@surgicaleducation.com.Commercial Promotion LevelsSelect your levelselect onePlatinum Level-$10,000Gold Level – $5,000Silver Level – $2,500Platinum Price: Includes: Recognition as supporter of Thinking Out of the Box and Candlelight Session Invitation to and recognition at the Awards Banquet (two tickets) Banner ad in ASE meeting app with hyperlink to company website One exhibit space in prime location (placement based on availability) Recognition on break slide (separate slide with logo) Recognition on poster in meeting foyer Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo, company description and web linkGold Price: Includes: One exhibit space in prime location (placement based on availability) Recognition on break slide with logo Recognition on poster in meeting foyer Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo, company description and web linkSilver Price: Includes: Recognition on break slide with logo Recognition on poster in meeting foyer Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo, company description and web linkVisibility OpportunitiesSelect your opportunityselect oneLittle Scrubs Club – $5,000Lunch and Learns (plus cost of food & beverage/AV) – $5,000URiM Trainee Scholarships – $2,000Finding Aspiring Surgeons for Tomorrow Community Outreach Event – $1,500Family Care Grants – $1,500Scientific Posters – $1,500Refreshment Breaks – $1,500SEW App Banner Ad – $1,500Little Scrubs Club Price: The ASE will be offering a fully licensed childcare service on-site during the 2026 Annual Meeting. Located on the same floor as the general session room, meeting attendees can rely on: safe, secure, and supervised care for children ages six months to 12 years. age-appropriate activities including arts, games, and storytelling qualified, background-checked childcare professionals flexible scheduling options to suit attendee schedules By sponsoring this brand new initiative, you’ll be allowing attendees peace of mind, knowing that their children are nearby in a safe, engaging and nurturing environment.Lunch and Learns (plus cost of food & beverage/AV) Price: Participating companies will have the chance to host an educational Lunch & Learn event during the ASE Annual Meeting on Wednesday, April 29th. Lunch is not provided for general meeting attendees so this is a unique opportunity for them to have lunch at the hotel while attending an educational session of your design with your chosen presenters (to be approved by program chair in advance). While not considered part of the official ASE program, these events will be promoted in the meeting app and eblasts to pre-registrants.URiM Trainee Scholarship Price: The ASE DEI committee is offering two travel scholarships in the amount of $1,000 each for trainees who are considered underrepresented in the surgical community and who are interested in attending the Annual Meeting. The scholarship funds would be used to cover the costs of meeting attendance such as airfare and hotel lodging. This initiative is in keeping with the ongoing mission of the ASE to make a home for all in the surgical education community, encompassing a commitment to Diversity, Equity and Inclusion (DEI). Commercial Promotion will include: Recognition on break slide with logo Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo and web linkFinding Aspiring Surgeons for Tomorrow Community Outreach Event Price: This event will be organized jointly with the APDS to spread awareness of career opportunities in the medical field. Monetary and in-kind sponsorships (laparoscopic box trainers) will be accepted. Commercial Promotion will include: Recognition on break slide and signage with logo Recognition of support by Event Chair during event Recognition of support by ASE and APDS presidents during opening and closing remarks and Awards Banquet Acknowledgement in meeting apps with logo and web linkFamily Care Grants Price: Several $500 scholarships will be awarded to alleviate childcare burdens for ASE members traveling to the meeting. These scholarships can be used to support travel of another caretaker to the meeting, childcare in Atlanta, or to secure childcare arrangements at home while the ASE member attends the meeting in Atlanta. This initiative was launched to encourage in-person meeting attendance by ASE members in the early stages of their career. Commercial Promotion will include: Recognition on break slide with logo Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo and web linkScientific Posters Price: The posters provide an opportunity for depicting ideas and research results. In addition, they provide a chance to discover and share activities in surgical education and to have individual discussions with the poster presenters. Requested abstract topics for the meeting include: AI Assessment Curriculum Development Diversity, Equity, and Inclusion Education Technology Faculty Development Global Surgical Education Interprofessional Education Leadership Program Evaluation Recruitment and Selection Simulation Teaching Methods Wellness/Well-Being Other Commercial Promotion will include: Recognition on break slide and signage with logo Recognition of support by ASE president during opening and closing remarks and Awards Banquet Acknowledgement in ASE meeting app with logo and web linkRefreshment Breaks Price: The refreshment breaks will be held in the exhibit area, in the foyer immediately outside of the general session room. Commercial Promotion will include: Recognition on break slide and signage with logo Recognition of support by ASE and APDS presidents during opening and closing remarks and Awards Banquet Acknowledgement in meeting apps with logo and web linkSEW App Banner Ad Price: Scrolling advertisement on the home page of the ASE meeting app (includes hyperlink to advertiser’s website)Banner AdvertisementsBanner Ads QuantityFormat – JPEG: 640 Pixels wide x 160 pixels high (rectangles only) Text – 340 pixels width (readable left to right) Images – static only (no animations) Links – must provide URL NOTE: Ads should be configured as 980 x 90 rectangles. Price: $1,500.00 Quantity Ad ArtworkMax. file size: 512 MB. Hyperlink- ads will be linkable to a company website or microsite. This field is hidden when viewing the formTime Options Tuesday, April 27th, 6:15pm Wednesday, Aprtil 28th, 6:30pm PaymentPlease make checks out to the Association for Surgical Education and mail to the address below: Association for Surigcal Education 11300 W. Olympic Blvd, Suite 600 Los Angeles, CA 90064 Memo: Industry PromotionsTOTAL Payment Options*select oneCheck – please send invoiceCredit CardCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name
