Special Event Request Form

Please fill out and submit this form by the appropriate deadline to schedule an event at the 2019 ADSA^® Annual Meeting in Cincinnati, Ohio.

You will be contacted to confirm meeting details, food and beverage preferences and audio/visual needs.

Special Event Request Deadline

Ticketed Events (to appear on Registration Form): November 30, 2018

All Other Events: April 1, 2019

The 2019 ADSA Annual Meeting will be held June 23-26, 2019 (Sunday through Wednesday). The opening session will be held on Sunday evening, June 23; Sessions will kick off Monday morning, June 24, and run through Wednesday at 5:30 pm, June 26.

All fields are required unless otherwise noted.

Official Title of Event

Sponsoring Company/Organization (if applicable)

Type of Event

Meeting with Multiple Food & Beverage Needs
Meeting with Break Only
Meeting without Food & Beverage
Breakfast Only
Lunch Only
Dinner Only
Reception Only

Ticketed Event on Registration Form

Yes
No

Event to appear in Schedule of Meeting Events

Yes
No

Audio-Visual Needs

Yes
No

Preferred Date

Saturday, June 22 (Pre-meeting events)
Sunday, June 23 (Pre-meeting events, Opening Session, Opening Reception)
Monday, June 24 (First full day scientific sessions, ADSA Awards Program)
Tuesday, June 25 (Full day scientific sessions)
Wednesday, June 26 (Full day scientific sessions, post-meeting events)
Thursday, June 27 (Post-meeting events)

Time of Event

Approximate Number of Attendees

Preferred Location for Event

Duke Energy Convention Center
Hyatt Regency Cincinnati (ADSA HQ Hotel)
Location To Be Determined

Name

Company/Organization

Address

Country

Phone

Fax

Email