2010 - Winter - Deaf Seniors of America, Inc.

Business/Organization Name:

Status:

For Profit

Deaf Owned

Nonprofit (please provide proof of NFP status)

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name

First Last

Position:

Daytime Phone/TTY/VP:

Fax

Early Bird Special (end December 31st, 2022):

Rates

$750 For Profit

$525 Deaf Owned/Nonprofit

Standard Rate:

$1,000 For Profit

$700 Deaf Owned/Nonprofit

Exhibit Reservations

Number of booths: For more than five booths, please contact: dsa2023exhibition@deafseniors.us

One

Two

Three

Four

Check here if requesting information for interpreting services (at exhibitor’s expenses)

Program Book Identification/Booth Description Sign

Please print the following information exactly as you wish it to appear in the program book and booth identification sign:

Business/Organization name:

Program Book Identification/Booth Description Sign

Name

City State / Province / Region

Website

Cancellation of Exhibit Contract Should an exhibitor wish to cancel this contract, the refund schedule is as follows: 1) Notification of cancellation on or before March 14, 2023 – 100% refund of total contracted cost, and 2) Notification of cancellation after March 14, 2023 or if exhibitor fails to occupy the space, no refunds. Note: Exhibitor contracts are not considered cancelled unless exhibit coordinator has received note in writing. No exceptions.

Exhibit Agreement Exhibitor signature below stipulates having read and agreed to the complete 2023 DSA conference exhibitor Rules and Regulations which are incorporated into this contract by reference. The Application becomes a contract when accepted and confirmed by DSA exhibit coordinator. All fees are to be paid in full upon submission of signed contract.

Type your name and it will be considered as a signature:

Position:

Print name of representative:

Payment Section

Credit card information and this contract can also be faxed. A $40- charge will be assessed on all returned checks.

Check/cashier’s check/money order enclosed (payable to DSA2023Hollywood)

Credit Card (select type):

Visa

Mastercard

Total

16 Digit Account Number:

3 Digit CCV Code:

Full name shown on card:

Name

This field is for validation purposes and should be left unchanged.

MAIN PRESENTER

First Last

Degrees (if applicable)

Self or Organization (if applicable)

Position

VP/Text

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

ADDITIONAL PRESENTER/PANELIST

First Last

Degrees (if applicable)

Self or Organization (if applicable)

Position

VP/Text

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

BIOGRAPHY(Required)

Please submit your biography relevant to your qualifications for this presentation. Your biography will be printed in the conference program and posted on our web. Please submit up to 300 words in a written/narrative format and NOT a CV/resume.

SESSION TITLE(Required)

Titles should be concise and intriguing. Attendees will choose from up to five (5) other session titles per time block.

SESSION DESCRIPTION(Required)

Descriptions should be no more than 100 words and will be printed in the program book. Suggested format: Describe the activities that will result in the projected outcomes

AUDIO VISUAL [AV] EQUIPMENT

Please describe what AV your presentation requires, such as flipcharts, PowerPoint, video clips etc. PLEASE NOTE: DSA 2023 Conference DOES NOT PROVIDE LAPTOPS.

TOPIC OF YOUR PRESENTATION - Please consider below outlined bullet points when developing your write up. Explain how you will convey the content to the participants. Kindly describe in the space below:

• Your proposal in detail including specific examples, goals and objectives

• Your expertise in the topic you select to discuss

• Strategies that support overcoming obstacles, best practices, how can one implement these strategies across the deaf senior community

DSA2023 accepts APPLICATIONS in 3 different formats - workshop, lecture, and/or panel. All sessions will take place between June 26 through 28, 2023.

Please check off all boxes that apply.

One time-1 hour- AM or PM

Concurrent Workshop Sessions

1 hour / taking place in the morning and REPEAT in the afternoon.

FORMAT

WORKSHOP: Up to three [3] individuals providing hands-on content with attendees learning practicing skills, tools, & strategies.

LECTURE: Up to three [3] individuals providing an in-depth case study with attendees learning topical/industry specific best practices & strategies.

PANEL: up to 5 participants on a panel sharing experiences and/ or viewpoints.

ROOM SET UP - Session rooms are set in theatre style. We try to accommodate set up when possible, please list your preference below:

2 rows - seated with 30-40 participants

Classroom - rows of tables & chairs

Other - Please describe:

Additional Information from the presenter(s)

Please offer in the space below any additional information that the program committee should be aware of when reviewing your submission/presentation.

This field is for validation purposes and should be left unchanged.

Name*
First Last
Email*
Phone
Message*
Email
This field is for validation purposes and should be left unchanged.

Call for Exhibitors

Call for Presentations

DSA 2023 Hollywood, FL Raffle

Contact the Deaf Seniors of America, Inc.