Exhibitor - Greater Illinois Pediatric Palliative Care Coalition

GIPPCC collaborates with its members to educate, advocate for, and partner with consumers, healthcare providers and the
community in order to improve and increase access to palliative care and bereavement services for children and families
throughout Illinois.
JUNE 11, 2015 GIPPCC EDUCATION CONFERENCE
EXHIBIT PROSPECTUS
Board of Directors
March 25, 2015
Donna Medina,
President, Education
Committee, Chair
Dear GIPPCC Supporter,
Mimi Noonan,
Vice President
Mary Runge,
Treasurer
Kristen Drago,
Treasurer
Erin Flanagan, M.D.
Joel Frader, M.D.,
Clinical Committee,
Chair
Richard Kasper
Meggan Mikal
Phillip O’Brien
Laura Sollenberger
Karen Short
Lora Wyatt
On behalf of the hospitals, hospices, supporting organizations and individual members
of the Greater Illinois Pediatric Palliative Care Coalition (GIPPCC), we invite you to
participate in the June 11, 2015 GIPPCC Education Conference, entitled Pediatric
Palliative Care: From Prenatal Support through Bereavement Services. GIPPCC has a
rich history of offering education programming for providers; the June 11 event
represents GIPPCC’s second regional pediatric palliative care conference. The
conference will be held at The Chateau Hotel and Conference Center located at 1601
Jumer Drive, Bloomington, Illinois 61704.
GIPPCC anticipates attendance from approximately 150 pediatric palliative care
clinicians from Illinois, Indiana, Wisconsin, Iowa and Missouri. Participating providers
include physicians, nurses, administrators, social workers, expressive therapists,
chaplains, child life therapists, parents and others interested in pediatric palliative care.
These providers represent hospitals, hospices, home care agencies, other organizations
that support children with life limiting illnesses, and individuals committed to the
advancement of improved care and services for children with potentially life limiting
illnesses.
Staff
Kimberly Downing
RN, JD
Project Coordinator
kdowning@horizonho
spice.org
Jennifer Misasi
PNP-BC
Pediatric Palliative Care
APN
jmisasi@horizonhospi
ce.org
Molly Heineman
GIPPCC Assistant
mheineman@horizon
hospice.org
833 W Chicago Ave
Ste 300
Chicago IL 60642
www.gippcc.org
We graciously invite your participation as an exhibitor at this event. Your involvement
will help further dialogue between clinicians and supporting resources. Information
about exhibit opportunities can be found below. Register as an exhibitor before May 1,
2015 and receive a $50 discount off the exhibitor fee.
Additionally, GIPPCC is seeking sponsors for the program. Sponsorship levels at
$2500, $1000, and $500 are available. Any sponsorship of this type will be recognized
in the program for the event and on our website and Facebook page. Please note that
GIPPCC is a 501 (c)(3) non-profit organization. If you are interested in sponsorship
opportunities, please contact Molly Heineman at 312-733-8900, or via email at
mheineman@horizonhospice.org.
Thank you in advance for your support of GIPPCC and our regional efforts to improve
care for children with life limiting illnesses in Illinois. If you have any questions, we
warmly welcome you to contact Molly Heineman using the contact information noted in
the preceeding paragraph.
Take Good Care,
Kim Downing RN, JD
Project Coordinator, Greater Illinois Pediatric Palliative Care Coalition
The Education Committee Members thank you for sharing your time to participate in this programming.
Donna Medina, Chair, GIPPCC President, OSF Home Care Services, Peoria
Kristen Drago, GIPPCC Secretary, JourneyCare, Barrington
Abby Woods, Southern Illinois Healthcare, Carbondale
Laurie Mungovan, Joliet Area Community Hospice, Joliet
Marg Wydra, Rush University Medical Center, Chicago
Mimi Noonan, GIPPCC Vice President, Parent Representative,
Veterinary Specialty Center, Deerfield
Margaret Rudnik, GIPPCC Consultant, Chicago
Karen Short, GIPPCC Board Member, VNA Hospice, Rockford
Jennifer Misasi, GIPPCC APN, Chicago
Laura Sollenberger, GIPPCC Board Member, Children’s
Hospital of Illinois, Peoria
Molly Heineman, GIPPCC Assistant, Chicago
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June 11, 2015
Exhibitor Information
All Exhibitors receive the following benefits:
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A six foot table draped with linen
One complimentary conference registration for an exhibit representative
Quarter page advertisement space in the conference program
Business card sized advertisement in the GIPPCC bi-annual newsletter
Listing on GIPPCC website as conference exhibitor for the education event (www.
GIPPCC.org)
Exhibit Times
Thursday, June 11, 2015
7:00 am-7:30 am
Set up
7:30 am-8:30 am
Registration and Continental Breakfast
11:00 – 11:15 am
Morning Break
12:15 – 1:30 pm
Lunch Break
2:30 – 2:45 pm
Afternoon Break
Exhibit Fees
Early Bird Special
$200
(Full fee must be received prior to May 1, 2015)
Regular Fee
$250
(Fee received after May 1, 2015)
Exhibiting Terms
Cancellation/Refund Policy: Any cancellations must be received by GIPPCC in writing. Due
to the advance preparations required for this conference, there will be no refunds for
cancellations after May 25, 2015.
Exhibitor Registration and Payment: The exhibitor agrees to comply with all rules, guidelines
and regulations outlined in this document. GIPPCC must receive full payment of the exhibitor
fee to reserve space. Payments should be directed to the Greater Illinois Pediatric Palliative Care
Coalition or GIPPCC. Exhibitor fees must be paid by May 25, 2015. An exhibitor’s registration
for space (page 5 of this prospectus), once received by GIPPCC, constitutes a contract for the
right to use the space, subject to receipt of full payment for space rental.
Submissions: Ads and logos must be received by the dates indicated below. Any mailings sent
to GIPPCC members will be approved by GIPPCC staff prior to publication.
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Entity name, logo and brief description for the GIPPCC website must be received by GIPPCC no
later than 5pm on May 10, 2015.
Developed advertisement for conference brochure must be received by GIPPCC no later than 5pm on
May 10, 2015.
Space Assignment: There will be dedicated exhibitor space within the conference area.
Assigned spaces may be transferred or changed by GIPPCC in its sole discretion in response to
reasonable requests and safety concerns (for example, avoidance of congestion). Space is
limited. GIPPCC reserves the right in its sole discretion to select and approve all exhibitors.
Exhibitor Arrival: All exhibitors must register at the registration desk inside the exhibit hall
where badges and conference materials will be distributed. All representatives are required to
wear badges while in the exhibit area. Exhibitor registration will open at 7am on June 11, 2015.
Staffing: Representatives of the sponsoring company must staff exhibit spaces at all times
during the exhibit hours. Those solely staffing their exhibit may take brief breaks.
Disclosures of Investigation Uses of Products, Devices of Procedure: All exhibitors are
required to follow the Food and Drug Administration (FDA) rules and regulations on displayed
projects. These rules require disclosure of current FDA status by appropriate labeling and
pharmaceuticals. Further information may be obtained from the FDA.
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Exhibitor Registration
Company Information
Company
Name:
Street
Address:
City/State/Zip:
Contact Name:
Contact
Phone:
Contact Email:
Name Badge:
Second Name
Badge:
Exhibitor Information (Indicate Chosen Option with an “X” in last column)
$200
$250
Early Bird Discount Rate(must register prior to 5/1/15)
Traditional Rate
Additional Information
Electricity
(an additional fee
of $15 will apply)
Other AV
Does your exhibit require and electrical outlet?
Y
N
Does your exhibit require additional AV support?
(Please specify on line below)
Y
N
**Electricity is available for exhibitors. Please indicate on the registration form if your exhibit
needs access to an electrical outlet. The $15 fee associated with electrical access will be the
responsibility of the exhibitor.
Payment Information
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Mail exhibitor registration with check payable to GIPPCC to
Greater Illinois Pediatric Palliative Care Coalition
c/o Horizon Hospice & Palliative Care
Attention: Molly Heineman
833 West Chicago Avenue, Suite 300
Chicago, IL 60642