Drury Plaza Hotel Indianapolis Carmel

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SPONSORS & EXHIBITORS REGISTRATION PACKET Drury Plaza Hotel Indianapolis Carmel (I-465 at US 31 - N. Meridian St) 9625 North Meridian Street Indianapolis, IN 46290 To register as an Event Sponsor or Exhibitor, please complete: 1. Commitment Form on page 3, 2. Booth Information Form on page 4, 3. Registration Form (each attendee must complete a form) on page 5. 4. Return all three forms to the Committee no later than March 1, 2017. This will reserve your event sponsorship or exhibitor booth space and will ensure that you will receive recognition in our early promotional materials. Payments do not need to be submitted with the forms, but payment must be received by March 10th to guarantee your event sponsorship or exhibitor booth. 1 2/7/2017

Sponsorship Levels & Benefits The Indiana State Association of Health Underwriters will be holding their 3rd Medicare Summit at the Drury Plaza Hotel Indianapolis Carmel, 9625 North Meridian Street, Indianapolis, IN 46290 on Monday, March 20, 2017. We are anticipating over 200 agents and industry professionals to attend this event. We have several sponsorship and exhibitor opportunities listed below. Please select the level of your choice. Complete and return your Commitment Form (page 3), the Sponsors & Exhibitors Booth Information (page 4), and the Attendees Registration Form (page 5) by mail or email to reserve your space no later than March 1, 2017. Payments do not need to be submitted with the Premier Event Sponsor - Carrier Level - $1,000 8 x 6 Exhibitors Booth 2 Complimentary tickets to the event Signage on stage with company name & logo Welcome presentation to group - opening program Full page ad in the Program Book Logo on marketing materials Please call or email to confirm availability for Event Sponsorships & Exhibitor spaces!! Premier Event Sponsor - Brokerage Level - $1,000 8 x 6 Exhibitors Booth Continental Breakfast Sponsor - $500 2 Complimentary tickets to the event 8 x 6 Exhibitors Booth Signage on stage with company name & logo 1 Complimentary ticket to the event Welcome presentation to group - opening program Logo & 20 word blip in the Program Book Full page ad in the Program Book Logo on marketing materials Logo on marketing materials Lunch Sponsor - $ 750 Bag Sponsor - $500 Signage at the event with company name & logo Logo & 20 word blip in the Program Book Welcome presentation to group at lunch (5 minutes) Logo on marketing materials Logo & 20 word blip in the Program Book Your convention bag with logo distributed to all attendees Logo on marketing materials Afternoon Break Sponsor - $500 Program Book Sponsor - $500 Logo & 20 word blip in the Program Book Full page ad in the Program Book Logo on marketing materials Logo on marketing materials All Day Beverage Service Sponsor - $500 Nametag Sponsor - $500 Logo & 20 word blip in the Program Book Choice: You provide lanyards with logo or we print logo on nametags Logo on marketing materials Logo & 20 word blip in the Program Book Keynote Speaker Sponsor Exhibitors - $300 Logo & 20 word blip in the Program Book Logo & 20 word blip in the Program Book Logo on marketing materials Logo on marketing materials Introduces the Keynote Speaker 2 Limited Spaces!

SPONSORS & EXHIBITORS COMMITMENT FORM (See full details on Sponsorship Levels & Benefits on page 2.) Please check the level of Sponsorship desired for your company: Event Sponsor - Carrier - $ 1000 Event Sponsor - Brokerage - $ 1000 Continental Breakfast Sponsor - $ 500 Lunch Sponsor - $ 750 Afternoon Break Sponsor - $ 500 All Day Drink Sponsor - $ 500 Program Book Sponsor - $ 500 Event Bag Sponsor - $ 500 Keynote Speaker Sponsor - $ 500 Name Tag Sponsor - $ 500 Exhibitor Booths - $ 300 Company Name: Company Mailing Address: City: State: Zip: Phone: Fax: Primary Contact Person: Primary Contact Person s Email: Who should we contact for logos and ads? Contact Person: Contact Person s Email: Who should we contact for booth setup and event attendance? Contact Person: Contact Person s Email: Payments must be received before March 10, 2017. Submit completed forms & check payments to: ISAHU Medicare Summit Committee 3330 Thames Drive, Fort Wayne, IN 46815 or email forms to: treasurer@isahu.org 3 DEADLINES 3/1/17 - Commitment Form, Booth Form & Registration for each person who will be using Complimentary Tickets must be submitted. 3/10/17 - Sponsorship & Exhibitor fees are due. Please call or email to confirm Sponsorship & Exhibitor availability! Check payment attached (Check # ) Please send an Invoice to our Company Contact Person.

Please complete the following booth information. Submit completed forms to: ISAHU Medicare Summit Committee, 3330 Thames Drive, Fort Wayne, IN 46815 or scan & email to: treasurer@isahu.org Questions? Call Rita Musser (260) 471-8232 or Nicole Fairbairn (317) 774-7511 Sponsors and Exhibitors Booth Information Form (See Full Details on Sponsorship Levels and Benefits on Page 2) Exhibit booth space is approximately 8 L x 6 D and will include a 6 x 30 skirted table and two chairs unless indicated below. Exhibitor set-up is scheduled for Sunday, March 19th from 6:00 pm - 8:00 pm or Monday, March 20th from 6:30 am - 7:45 am. Booths set-up must be completed before 7:45 am, March 20th. 1. Please answer the following questions so we may ensure your booth is placed appropriately for your needs. We cannot guarantee we will be able to accommodate special requests, but will do our best to meet your needs. Will you need power at your booth? Yes No Will you need a table for your booth? Yes No If you have a standalone display, please provide the dimensions of your display: Length Depth Height Will you be bringing your own table covering? Yes No Will you need skirting for your booth? Yes No 2. Company Blip for Convention Program Book (20 words or less): 3. Please submit a color camera-ready company logo (300 dpi minimum) in.jpg format via email to: treasurer@isahu.org no later than March 1, 2017 for inclusion in printed event promotional materials. (NOTE: We are not able to png or epi formats!) 4

Sponsors & Exhibitors: To register employees who will be using your company s Complimentary Tickets, please have each person complete a Registration Form below. Refer to page 2 for the number of Complimentary Tickets you will receive at your sponsorship level. This form can also be used to register additional registrations that you wish to add. You may have additional people at your booth, but any not covered by a Complimentary Ticket must pay the registration fee at the member rate. All registration forms must be received by March 1, 2017. Registration Form Name: (As it appears on your insurance license) Company: Street Address: City, State, Zip Code: Phone: Fax: Email Address: Contact person and telephone number in case of an emergency: Are you a NAHU Member? Chapter: Sponsors & Exhibitors are welcome to attend our Continuing Education courses. If you need C.E. credits, you must sign into each class at the event and indicate your NPN number and licensing state below! NOTE: Our courses are only filed for Indiana CE credits. National Producer Number: State of Residence for License: As stated above, you are welcome to join us for all sessions and CE programs. However, we realize that many sponsors and exhibitors use these times to do their own work. Please indicate below whether you anticipate that you will or will not to be in the sessions and CE programs, so that we can maximize our attendance numbers and space. Yes, I will be attending all sessions and CE programs. No, I will not be attending the sessions and CE programs. Mail completed Commitment Forms, Booth Information Form, Registration Forms and checks to: ISAHU Medicare Summit Committee 3330 Thames Drive, Fort Wayne, IN 46815 or email forms to: treasurer@isahu.org 5

Sponsors & Exhibitors - General Information Thank you for your support of the 2017 ISAHU Medicare Summit. The following general information is for sponsors & exhibitors regarding our events and the conference site. If you have any questions or concerns, please do not hesitate to contact: Medicare Summit Committee Drury Plaza Hotel - Indianapolis Carmel Nicole Fairbairn Lauren Bartos - Sales & Meeting Coordinator (317) 774-7511 9625 North Meridian Street cicnfw@gmail.com Indianapolis, IN 46290 lauren.bartos@druryhotels.com Rita Musser (317) 814-3247 (260) 471-8232 treasurer@isahu.org SHIPPING BOOTH MATERIAL PRIOR TO THE EVENT: Packages for our event may be delivered to the conference center no more than two (2) days prior to the day of the event as the conference center has limited storage space available. Please notify the Drury Plaza Hotel s Sales & Meetings Director as to the number and size of any packages that you expect. To ensure proper delivery, the following information must be included on all packages: Venue Name: Venue Address: Drury Plaza Hotel - Indianapolis Carmel 9625 North Meridian Street Venue City/State/Zip: Indianapolis, IN 46290 Hold for: (Name of Guest picking up packages) Event Name: ISAHU Medicare Summit Event Date: March 20, 2017 Written permission is required for any heavy equipment to be brought into the facility. The Drury Plaza Hotel - Carmel is not responsible for transferring any equipment to / from meeting rooms. Shipments over 100 pounds will not be accepted or moved by facility employees. Planners requiring drayage and exhibit setup should contact the Conference Service Department for a list of approved vendors. No COD packages will be accepted. SET UP / TEAR DOWN: Booth Set Up Times: Sunday, March 19th from 6:00 pm thru 8:00 pm. Monday, March 20th from 6:30 am thru 7:45 am. (First vendor visit is scheduled for 8:00 am on March 20th.) Booth Tear Down: After the closing program on March 20th. (Approximately 4:30 pm) 6