Name
*
First Name
Last Name
Company Name
Email
*
Phone
*
(###)
###
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What type of event are you planning?
*
Please list all that apply.
- In-Person Event
- Hybrid Event (Combination of Live and Virtual Meeting)
- Virtual Event
- Hands-On Cadaver Lab
What type of support do you need?
*
Will this course be for CME credit?
*
What range is your budget?
*
Name of Event/Course
Do you require a set-up day?
Purpose of the event/course.
*
Please select all that apply.
Please briefly describe your course/event.
*
How many participants do you expect?
*
How many personnel do you expect (sales reps, support staff, etc.)
*
Which parts of our facility are you interested in using?
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Please select all that apply.
Tissue: How many specimens and what kind do you need?
Please provide details.
Lab - How many individuals will be participating in the lab?
Lab- How many stations do you need?
Lab - Will any equipment being shipped come in oversized crates or packages? If yes, please describe and list estimated number of crates/packages.
Do you require catering?
*
Please check all that apply.
Catering for how many guests?
Audio/Visual
What are your a/v needs? (e.g. live case, teleconferencing, live web streaming, recording , connecting medical imaging equipment to monitors, presentation/computer setup, etc.)
How many presenters do you expect?
Virtual Event - How many total sessions?
Virtual Event - What is the duration of each session?
Virtual Event - Would you like to include a virtual trivia game?
Would you like to host the recorded presentations on www.ssftv.org?
