Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 2
Contents MAFP by the Numbers ........................................................................ 3
Partnership Opportunities .................................................................. 4
Your Benefits—Explained ................................................................... 6
Event Logistics ..................................................................................... 9
Resource Center Logistics ................................................................. 10
Invitation Letter for Decision Makers ............................................... 12
MAFP W9 .......................................................................................... 13
Registration Form ............................................................................. 14
Let’s Chat! ......................................................................................... 16
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 3
MAFP by the Numbers
Founded in 1948, the MAFP represents more than 3,100 family physicians,
family medicine residents and medical students. It is the largest medical specialty organization in Minnesota and a state chapter of the American Academy of Family Physicians (AAFP), one of the largest national medical organizations in the United States, with more than 134,600 members.
3,170 members strong
308 average number of
attendees at Spring
Refresher (since 2015)
33% open rate for email
marketing to all
members (since 2014) (industry average is 21%)
2,146
327
246
421
21
9
active
students
residents
life
inactive
other
86% market share 86% of family physicians in Minnesota belong to the MAFP (as of December 2018)
Age Employed/
Business Owner Urban/
Rural Practice
20-29 30-3940-49 50-5960-69 70+
Sole ownerPartial ownerEmployed
Metro area (pop. 20,000+)RuralUnknown
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 4
Partnership Opportunities
You can choose among three levels of partnership
packed with benefits. Contact us for suggestions
about what will work best for your goals and
budget. We have some exciting changes! Our goal is to create meaningful connections for family physicians through an experience that benefits both you and them. We have specifically designed our new partner offerings with input from past exhibitors/sponsors AND Minnesota family docs.
Our new one-day Physician Resource Center is an exhibit hall re-imagined. Among other improvements is grouping partners by medical condition (clinical) and resource (non-clinical) so physicians can easily find the tools, resources, technology and products most important to them and their patients.
Opportunities
Choose the partnership level that meets your organization’s marketing and brand awareness goals. See benefits summary for detailed email, social media, print and website promotions.
Level Investment
Gold $7,500 limited to four partners
Silver $4,000
Bronze $1,500
Nonprofits & Public Health Scholarships For 501(c)(3) healthcare organizations and public health entities with missions to educate patients, provide patient services and advocate for patients in Minnesota. To learn more, visit mafp.org/SR-partner-scholarship.
Top reasons to partner
1 ACCESS
up to 300 family physicians through your on-site conference
display
2 INCREASE
AWARENESS
of your patient resources to 3,100+ family physicians through the organization
dedicated to their specialty
3 EDUCATE
family physicians eager to transform and improve their
practice
*Must be approved by the MAFP prior to production and delivered by deadline. See the Approvals & Delivery section for details. †Pharmaceutical and medical device companies are excluded from this benefit per our CME guidelines.
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 5
Benefits at a Glance
The following benefit options are available to you, depending upon your selected partnership level. The partnership registration form provides the opportunity for you to select which benefits you will use.
See the Benefit Descriptions section for important details about each benefit listed here.
Benefits (before and during the conference) Gold* $7,500
Silver $4,000
Bronze $1,500
Resource Center Theater – 30-minute non-CME session/video/presentation* Podium Time† – opportunity to address attendees* for 2 minutes Recognition and Introduction – at a general session Swag Station – one item* at swag station/in conference bag Display Banner* – placed in high-traffic area Social Media & App – company logo on MAFP social media + one push notification* via conference app
Mailing List – attendee mailing data for one pre-conference mailing* to attendees Hotel Room Drop – one print piece* placed in attendee guest rooms at conference hotel Logo Recognition – in conference communications to MAFP members (before, during and after)
Media Center – non-CME video* in Resource Center Resource Center Table – table with 2 chairs in Resource Center on Saturday, March 28 Partner Listing – company description and link on conference website and within conference app
Scavenger Hunt Game – to enhance attendee/partner engagement and interaction Social Hour – option to engage with conference attendees during end-of-day social event Name Recognition – in conference communications to MAFP members (before and during)
Additional Benefits (after the conference) Gold* $7,500
Silver $4,000
Bronze $1,500
Leadership Meeting – one-on-one meeting with CEO and board member of the MAFP Magazine Article – three-quarter-page article* (provided by partner) about patient care Magazine Ad – one half-page ad* (provided by partner) Patient Resource Table – resource table at a future MAFP non-conference event
Magazine Ad – one third-page ad* (provided by partner) Magazine Subscription(s) – one-year subscription(s) Physician Resource Listing – company/organizational profile on MAFP website
*Gold level partnership is limited to four partners.
*Must be approved by the MAFP prior to production and delivered by deadline. See the Approvals & Delivery section for details. †Pharmaceutical and medical device companies are excluded from this benefit per our CME guidelines.
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 6
Your Benefits—Explained
Get to know your benefit options a little better.
Benefit Descriptions
We understand that your organization may have specific guidelines as to which benefits you can take advantage of. You will opt in or out of each benefit option during registration. Additional specifications and instructions for each benefit you select will be provided after registration. (Benefits listed as “limited to” are limited to that number of partners on first come, first served basis.)
Conference Benefits Levels Description
Resource Center Theater* (limited to 4)
one 30-minute non-CME session/video/presentation* on Sun., Mar. 29, in a designated theater zone in the Resource Center (script/video/slides must be approved by the MAFP)*
Podium Time*† (limited to 4)
opportunity to address attendees for 2 minutes (script must be approved by the MAFP)*; time and location assigned by MAFP staff; time/location opportunities include: Sat., Mar. 28, before morning general session; Sat., Mar. 28, before afternoon general session, Sun., Mar. 29, before morning general session, Sun., Mar. 29, lunch break
Recognition & Introduction (limited to 4)
by an MAFP physician leader during announcements prior to a general session (time assigned by MAFP staff)
Swag Station* one item* (provided by partner) placed at swag station near Resource Center entry; suggested items include tote bag (limited to 1), printed patient resource brochure/flyer, useful reusable trinket, etc.; partner provides 200 items
Display Banner* one retractable, pull-up banner* (provided by partner) placed in high-traffic area
Social Media & App* (limited to 2)
• company logo on MAFP Facebook, Twitter and Instagram • one push notification* via the conference app on Sat., Mar. 28
insertion deadlines apply; see Reservation Deadlines for Benefit Fulfillment section
Mailing List*
attendee mailing data for one-time use provided directly to partner’s selected mail house at least 2 weeks before the conference (conference attendees choose to opt in or out of the mailing list when registering for the conference; mailer must be approved by the MAFP*)
Hotel Room Drop* one print piece* included in welcome packet placed in attendee guest rooms at conference hotel; partner provides 100+ copies of piece
Media Center* non-CME video* in designated area within the Resource Center on Sun., Mar. 29, plus opportunity for one representative to be present in the Media Center
Logo Recognition
Name Recognition
• on conference webpage (published within 1 week of partner’s registration) • in two pre-conference digital promotions to all MAFP members • on conference intermission slides in session rooms • Gold & Silver: in direct mail conference promotional piece to all MAFP members • Gold & Silver: in one post-conference issue of Family Medicine Matters e-news to all
MAFP members
insertion deadlines apply; see Reservation Deadlines for Benefit Fulfillment section
*Must be approved by the MAFP prior to production and delivered by deadline. See the Approvals & Delivery section for details. †Pharmaceutical and medical device companies are excluded from this benefit per our CME guidelines.
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 7
Conference Benefits Levels Description
Resource Center Table
• 6' deep x 8' wide space (undraped) in Resource Center on Sat., Mar. 28 • 30" high, 6' long table (covered and skirted) and two chairs • 3.25 hours of dedicated face time with attendees • Gold & Silver: complimentary electrical hook-up if requested in advance
Partner Listing
• company listing with name, description and link on dedicated page of conference website and within the conference app
• Gold & Silver: logo included with listing
insertion deadlines apply; see Reservation Deadlines for Benefit Fulfillment section
Scavenger Hunt Game • to enhance attendee/partner engagement and interaction in the Resource Center (insertion deadline and instructions will be provided)
Social Hour
• option to engage with conference attendees during end-of-day social event • Gold: opportunity to address social event attendees for 2 minutes (limited to 2; time
assigned by MAFP staff)
(Social Hour will occur only with Gold or Silver partnership support)
Post-Conference Benefits Levels Description
Leadership Meeting one-on-one meeting with the CEO of the MAFP and a physician leader on the MAFP Board of Directors to be scheduled by the end of the year (2020)
Magazine Article* (limited to 3)
one three-quarter-page article* (provided by partner) about patient care published within Minnesota Family Physician, the MAFP quarterly magazine (must be used within the summer, fall, or winter issue following the conference; insertion issue to be assigned by the MAFP); insertion deadline and instructions will be provided
Patient Resource Table (at future event)
resource table at a future MAFP non-conference event for MAFP members held prior to March 2021 (MAFP to provide eligible event options to the partner)
Magazine Ad*
• partner-provided ad published within Minnesota Family Physician, the MAFP quarterly magazine (must be used within the summer, fall, or winter issue following the conference; insertion issue to be assigned by the MAFP)
• Gold: one half-page ad* (limited to 3) • Silver: one third-page ad* (limited to 3)
insertion deadline and instructions will be provided
Magazine Subscription(s)
• subscription(s) to four issues of Minnesota Family Physician, the MAFP quarterly magazine, beginning with the summer 2020 issue
• Gold: subscriptions for up to 4 contacts • Silver: subscriptions for up to 2 contacts • Bronze: subscription for 1 contact
subscription deadline and instructions will be provided
Physician Resource Listing
company/organizational profile, link and contact info for your local representative published on a new page of the MAFP website featuring patient-care resources for family physicians; listings will be published within one month following the conference and remain through March 2021 (insertion deadline and instructions will be provided)
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 8
Approvals and Delivery of Benefit Items
Partner is responsible for all aspects and costs of designing, producing and delivering the specified benefit item(s).
Approval – Benefit item (e.g. script, video, artwork) must be approved by the MAFP prior to production or by February 21, 2020, whichever is earlier.
Delivery –
Digital items (e.g. videos) must be delivered by March 1, 2020, to the MAFP office by email or file transfer.
Physical items (e.g. branded item, print piece) must be delivered no sooner and no later than March 26, 2020 (i.e., two (2) business days prior to the conference). All benefit item packages MUST be separate from Resource Center table packages and be labeled with the following information:
Your Company Name Minnesota Academy of Family Physicians Spring Refresher March 2020 ATTN: Kendra Myers box one of _____ Renaissance Minneapolis Hotel, The Depot 225 3rd Ave S Minneapolis, MN 55401
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 9
Event Logistics
Event Dates & Location
March 28 & 29, 2020
The Depot Minneapolis 225 3rd Ave S | Minneapolis, MN 55401 612-375-1700 | thedepotminneapolis.com
Key Deadlines
DEADLINE
Feb 21, 2020 Registration and payment
Feb 21, 2020 Benefit item (e.g. script, video, artwork) for MAFP approval prior to production
Mar 13, 2020 Cancellation to receive a full refund minus a $100 administrative fee
Mar 1, 2020 Delivery of final digital items to the MAFP
Mar 4, 2020 Hotel reservations at the MAFP group rate
Mar 26, 2020 Delivery of final physical items (to The Depot)
Cancellation
In the event of a cancellation, notice must be received, in writing, two (2) weeks before the event (by March 13, 2020) to receive a full refund minus a $100 administrative fee. Cancellations made after that date, when the partnership cannot be resold, will be ineligible for a refund and the MAFP will retain 100% of the partner’s contract obligation.
Reservation Deadlines for Benefit Fulfillment
The earlier you register, the more promotional benefits you will receive. Reserve your partnership by the following deadlines to take advantage of all of the recognition benefits available to you.
DEADLINE TO BE INCLUDED IN/ON:
Dec 31, 2019 Conference direct mailer (mailed mid-January)
Jan 15, 2020 Two electronic pre-conference promotions
Feb 21, 2020 One electronic pre-conference promotion
Mar 11, 2020 Event website
Event app
Event slideshow
Final pre-event social media and email marketing
Register by February 21 at mafp.org.
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 10
Resource Center Logistics
Schedule
SATURDAY, MARCH 28, 2020
6:00 - 7:00 AM Resource Center table move in
7:00 - 7:45 AM Breakfast in Resource Center
9:30 - 10:15 AM Dedicated time in Resource Center
12:30 - 1:30 PM Lunch in Resource Center
3:00 - 3:45 PM Dedicated time in Resource Center
3:45 PM Resource Center closes
3:45 PM Resource Center table teardown
5:15 - 6:00 PM Social Hour
SUNDAY, MARCH 29, 2020
12:00 - 1:00 PM Lunch, Resource Center Theater and Media Center in Resource Center (Gold and Silver partners only)
Hotel Reservations
Rooms are available at The Depot Minneapolis at a group rate of $153 per night (standard guest room). The reservation deadline for group rate hotel rooms is March 4, 2020. Reserve your room online or by calling 612-375-1700 or 866-211-4611 (ask for the Minnesota Academy of Family Physicians (MAFP) Block to get the group rate).
Parking & Deliveries
The parking ramp for The Depot Minneapolis can be entered on 5th Avenue South between 2nd Street North and Washington Avenue. Resource Center table partners should use the Great Northern Loading Dock Area to unload. Vehicles should be left unattended no longer than 15 minutes. Resource Center table partners are responsible for parking costs in the ramp.
Internet
Basic WiFi is available throughout The Depot. For dedicated lines, please work with The Depot’s Exhibitor Services Representative.
Shipping
Boxes shipped to The Depot can arrive no sooner than March 26, 2020 (i.e., two (2) business days prior to move-in). All exhibit hall packages MUST be labeled with the following information:
Your Company Name Minnesota Academy of Family Physicians Spring Refresher March 2020 box one of _____ Renaissance Minneapolis Hotel, The Depot 225 3rd Ave S Minneapolis, MN 55401
Official Service Contractor
Nicole Fitzgerald Convention Services Manager Renaissance Minneapolis Hotel, The Depot 612-758-7828 [email protected]
Venue Policies
The exhibitor assumes the entire responsibility and liability for losses, damages and claims arising out of exhibitor’s activities on The Depot Minneapolis (the Hotel) premises and will indemnify, defend and hold harmless the Hotel, its owner and its management company, as well as their respective agents, servants and employees from any such losses, damages and claims. Due to the layout of the Hotel, storage space is not available for display materials and/or show merchandise. At the conclusion of the set-up operation, all related equipment, crates and trash must be removed from the premises no later than the last day of the exhibit show period. No outside food and/or beverage service shall be permitted. Only bite-
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 11
sized (1 oz.) treats in original packaging may be distributed at exhibit booths. No helium balloons permitted in the exhibit hall.
Regulations
• The MAFP will not guarantee the security ofunattended tables.
• All Resource Center table displays must be installedand ready by 7:00 AM on Saturday.
• No Resource Center table displays may be removedprior to close at 3:45 PM on Saturday.
• Interference with normal traffic flow is not allowed.• Offensive promotions by Resource Center table
personnel will not be tolerated.• Orders may be taken, but Resource Center table
partners may not conduct sales transactions(exchange of money and goods) during the event.
• The MAFP reserves the right to deny table space toany company whose products do not contributedirectly to attendees’ medical practices.
• Resource Center table partners who fail to observeconditions of this contract or who, in the opinion ofthe MAFP, conduct themselves unethically will beasked to leave without refund.
Important Notes for Resource Center table Partners
• If you require electricity to your Resource Centertable, The Depot Hotel will assist you. Please visitmafp.org/SR2020-partner-resources for adownloadable form.
• Resource Center table reservations will be honoredwith a completed registration form and payment.Space can be reserved through mafp.org/SR-partner-registration or the registration formincluded in this prospectus.
• No Resource Center table secured may be subleasedexcept with the consent of the MAFP.
Resource Center Layout
This is our vision of the re-imagined Resource Center. Actual layout will vary depending on the mix of medical conditions and resources being represented. Click here or on the image to see a larger version online.
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 12
1400 Van Buren St NE Suite 215 Minneapolis, MN 55413-4605
952-542-0130 [email protected] www.mafp.org
Invitation Letter for Decision Makers
November 2019
Dear Partner,
The Minnesota Academy of Family Physicians (MAFP) is pleased to invite all health
systems, recruiters, healthcare organizations, patient advocacy organizations and
pharmaceutical and medical device industry partners to join us at our 2020 Spring
Refresher, Minnesota’s largest CME Conference planned by and for family physicians.
The MAFP represents more than 3,100 family physicians, family medicine residents and medical students. We are the largest medical specialty organization in Minnesota and a state chapter of the American Academy of Family Physicians (AAFP), one of the largest national medical organizations in the United States, with more than 134,600 members.
Approximately 300 family physicians, residents and students from throughout Minnesota are expected to attend this event. The Resource Center is your opportunity to exhibit, interact, educate and connect with our members about the products and services you provide.
• March 28 & 29, 2020, at the Renaissance Minneapolis Hotel, The Depot in Minneapolis, MN • One-day Resource Center on March 28 includes: 3.25 hours of dedicated time in the exhibit hall
(where all non-CME activities occur), dining and social activities • Resource Center table locations are allocated by medical condition (clinical) or resource (non-
clinical) category and at the MAFP’s discretion • Resource Center tables (exhibits) will be in a separate room outside of the education meeting
rooms • Education sessions are Saturday, March 28, and Sunday, March 29, 2020 • The MAFP’s tax ID number is 41-0804400
Register at mafp.org/SR-partner-registration or mail or fax your completed registration form and payment by February 21, 2020.
Online payment is preferred at time of registration. If necessary, checks may be made payable to:
Minnesota Academy of Family Physicians 1400 Van Buren St NE, Suite 215 Minneapolis, MN 55413
Sincerely,
Lisa Larson Meeting Planner [email protected] | 651-491-3747
Form W-9(Rev. October 2018)Department of the Treasury Internal Revenue Service
Request for Taxpayer Identification Number and Certification
Go to www.irs.gov/FormW9 for instructions and the latest information.
Give Form to the requester. Do not send to the IRS.
Pri
nt o
r ty
pe.
See
Spe
cific
Inst
ruct
ions
on
page
3.
1 Name (as shown on your income tax return). Name is required on this line; do not leave this line blank.
2 Business name/disregarded entity name, if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1. Check only one of the following seven boxes.
Individual/sole proprietor or single-member LLC
C Corporation S Corporation Partnership Trust/estate
Limited liability company. Enter the tax classification (C=C corporation, S=S corporation, P=Partnership) Note: Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is another LLC that is not disregarded from the owner for U.S. federal tax purposes. Otherwise, a single-member LLC that is disregarded from the owner should check the appropriate box for the tax classification of its owner.
Other (see instructions)
4 Exemptions (codes apply only to certain entities, not individuals; see instructions on page 3):
Exempt payee code (if any)
Exemption from FATCA reporting
code (if any)
(Applies to accounts maintained outside the U.S.)
Requester’s name and address (optional)
7 List account number(s) here (optional)
Part I Taxpayer Identification Number (TIN)Enter your TIN in the appropriate box. The TIN provided must match the name given on line 1 to avoid backup withholding. For individuals, this is generally your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity, see the instructions for Part I, later. For other entities, it is your employer identification number (EIN). If you do not have a number, see How to get a TIN, later.Note: If the account is in more than one name, see the instructions for line 1. Also see What Name and Number To Give the Requester for guidelines on whose number to enter.
Social security number
– –
orEmployer identification number
–
Part II CertificationUnder penalties of perjury, I certify that:1. The number shown on this form is my correct taxpayer identification number (or I am waiting for a number to be issued to me); and2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue
Service (IRS) that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I amno longer subject to backup withholding; and
3. I am a U.S. citizen or other U.S. person (defined below); and4. The FATCA code(s) entered on this form (if any) indicating that I am exempt from FATCA reporting is correct.Certification instructions. You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return. For real estate transactions, item 2 does not apply. For mortgage interest paid, acquisition or abandonment of secured property, cancellation of debt, contributions to an individual retirement arrangement (IRA), and generally, payments other than interest and dividends, you are not required to sign the certification, but you must provide your correct TIN. See the instructions for Part II, later.
Sign Here
Signature of U.S. person Date
General InstructionsSection references are to the Internal Revenue Code unless otherwise noted.Future developments. For the latest information about developments related to Form W-9 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/FormW9.
Purpose of FormAn individual or entity (Form W-9 requester) who is required to file an information return with the IRS must obtain your correct taxpayer identification number (TIN) which may be your social security number (SSN), individual taxpayer identification number (ITIN), adoption taxpayer identification number (ATIN), or employer identification number (EIN), to report on an information return the amount paid to you, or other amount reportable on an information return. Examples of information returns include, but are not limited to, the following.• Form 1099-INT (interest earned or paid)
• Form 1099-DIV (dividends, including those from stocks or mutualfunds)• Form 1099-MISC (various types of income, prizes, awards, or grossproceeds)• Form 1099-B (stock or mutual fund sales and certain othertransactions by brokers)• Form 1099-S (proceeds from real estate transactions)• Form 1099-K (merchant card and third party network transactions)• Form 1098 (home mortgage interest), 1098-E (student loan interest),1098-T (tuition)• Form 1099-C (canceled debt)• Form 1099-A (acquisition or abandonment of secured property)
Use Form W-9 only if you are a U.S. person (including a residentalien), to provide your correct TIN.
If you do not return Form W-9 to the requester with a TIN, you might be subject to backup withholding. See What is backup withholding, later.
Cat. No. 10231X Form W-9 (Rev. 10-2018)
Minnesota Academy of Family Physicians
✔ 501(c)6 nonprofit organization5 Address (number, street, and apt. or suite no.) See instructions. 1400 Van Buren St NE, Ste 2156 City, state, and ZIP code
Minneapolis, MN 55413-4605
4 1 0 8 0 4 4 0 0
1/01/20
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 14
Registration Form If using this “paper” form, save these pages and complete the form digitally before printing. Or, if completing by hand, please print neatly.
Part 1 of 2: Organization and Purchase Information All fields are required.
Organization Information
Please provide all information exactly as it should be reproduced in our promotional and on-site materials. ORGANIZATION NAME
WEBSITE URL
ORGANIZATION DESCRIPTION
Send your description (to be published on the conference webpage and in the conference app) to [email protected] as a single paragraph of up to 250 words in length (or approximately 1,750 characters, including spaces and punctuation). Your description should explain why family physicians should connect with you during (or after) the conference. Describe how you can help them improve their practice and patient outcomes. For example: Do you have information about a specific product or resource? Will you have experts available to answer questions or provide education? Will you have take-away resources/handouts, hands-on learning, or product demonstrations?
ORGANIZATION LOGO
Send your logo to [email protected] as a vectored art file (SVG, EPS, AI, or PDF) suitable for enlargement to any size. If you are unsure about what type or size of file to provide, consult with your marketing department or agency. (Please note: We cannot guarantee quality displays of logos on signs and other printed materials unless we are provided with a vectored art file.)
Contact Information
Primary Contact Billing Contact Billing Address NAME
NAME
EMAIL ADDRESS
EMAIL ADDRESS
DAYTIME PHONE NUMBER
PHONE TYPE
☐ Office ☐ Mobile DAYTIME PHONE NUMBER
PHONE TYPE
☐ Office ☐ Mobile
Partnership
☐ $7,500 Gold – limited to 4 partners ☐ $4,000 Silver ☐ $1,500 Bronze
$ TOTAL AMOUNT DUE
Make a Payment
The MAFP’s federal tax ID number is 41-0804400.
Online: Visit mafp.org/SR-partner-registration
By check: Mail completed form with payment to: Minnesota Academy of Family Physicians 1400 Van Buren St NE, Suite 215 Minneapolis, MN 55413
Acknowledgments and Signature
I acknowledge that, unless prior arrangement is made with the MAFP, payment in full for 2020 Spring Refresher Partnerships is required by February 21, 2020, and that no Resource Center table will be assigned or provided unless payment in full is received by that date.
I further acknowledge that notice of cancellation of 2020 Spring Refresher Partnerships must be received by the MAFP, in writing, by March 13, 2020, to receive a full refund minus a $100 administrative fee, and that cancellations made after that date, when the partnership cannot be resold, will be ineligible for a refund and the MAFP will retain 100% of the contract obligation.
CONTACT’S SIGNATURE
DATE
Online registration is preferred: mafp.org/SR-partner-registration
(A “Bill Me” option is available to generate an invoice for later payment when registering online.)
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 15
Registration Form Part 2 of 2: Benefit Selections All fields are required.
ORGANIZATION NAME
DATE
INITIALS
Partnership Benefit Selections
Please select all of the benefits that you will be taking advantage of (per your partnership level). You may change your selections later; however, bear in mind that many benefits have insertion deadlines. You will be provided with specific fulfillment instructions for your selected benefits after registration. CONFERENCE BENEFITS
☐ I don’t know yet ☐ Resource Center Theater ☐ Podium Time† ☐ Recognition and Introduction ☐ Swag Station ☐ Display Banner ☐ Social Media & App ☐ Mailing List ☐ Hotel Room Drop ☐ Media Center ☐ Logo/Name Recognition ☐ Resource Center Table ☐ Partner Listing ☐ Scavenger Hunt Game ☐ Social Hour POST-CONFERENCE BENEFITS
☐ I don’t know yet ☐ Leadership Meeting ☐ Magazine Article ☐ Patient Resource Table (at future MAFP member event) ☐ Magazine Ad ☐ Magazine Subscription(s) ☐ Physician Resource Listing
†Pharmaceutical and medical device companies are excluded from this benefit per our CME guidelines.
Resource Center Details
☐ I understand that the MAFP Resource Center has a “no direct sales” policy.
MY RESOURCE CENTER TABLE WILL REQUIRE ELECTRICITY
☐ Yes ☐ No ☐ n/a; not using a table
Resources Category
Please select the category that best matches the focus of your organization’s resources for family physicians. RESOURCE CATEGORY (select ONE) Clinical Care ☐ Adolescent health ☐ Cardiovascular ☐ ENT ☐ Endocrinology ☐ Geriatric medicine ☐ Infant and child health ☐ Maternity care ☐ Men’s health ☐ Mental health ☐ Oncology ☐ Preventive care ☐ Pulmonary ☐ Reproductive health ☐ Women’s health ☐ Other clinical care (specify below) Non-Clinical ☐ Social determinants/influencers of health ☐ Substance abuse resources ☐ Alternative health concepts ☐ Physician career resources ☐ Patient advocacy organization / Nonprofit
organization / Public health ☐ Other non-clinical (specify below) OTHER CATEGORY (if “other” selected above)
Minnesota Academy of Family Physicians – 2020 Spring Refresher Partnership Opportunities updated 2/4/2020 page 16
Let’s Chat!
We’re excited to chat with you about the best opportunities for your
organization! Let’s start the conversation today.
Contact our experts.
Resource Center Logistics
Lisa Larson Meeting Planner [email protected] 651-491-3747
Registration Logistics
Kendra Myers Executive Administration and Process Support [email protected] 952-224-3876
Partnership Benefits
Lynn Balfour Deputy Executive Vice President [email protected] 952-224-3872
MAFP Office
contact us
Or, if you’re ready to commit now, register your partnership.
Register online at mafp.org/SR-partner-registration (preferred) or complete the form in this prospectus.
Benefit fulfillment instructions will be provided upon receipt of a completed partnership registration form.