2011 ANNUAL CONFERENCEPhysical Therapy, the Frontline of Musculoskeletal Care

OCTOBER 26-30, 2011 DISNEYLAND® HOTEL | ANAHEIM, CALIFORNIA

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EXHIBIT OPPORTUNITIESExhibiting your company’s products and services at this

important event will give you the visibility to participate

in this gathering with OMPT physical therapists, fellows

and researchers, the majority of whom are also AAOMPT

members. The conference offers OMPT physical therapy

practitioners information and resources to advance

their skill level and increase proficiency in practice and

patient care. As an exhibitor, you have an unmatched

opportunity to help them achieve success in OMPT by

showcasing the latest information, research, products

and resources available.

There are abundant opportunities for meeting and informal networking with conference attendees:

— The Exhibitor area is central to the conference events and sessions, so it will be convenient for attendees to visit your booth.

— The poster presentations will be held within the exhibit area on Friday evening during a wine and cheese reception providing for an exchange of information and networking all in one location.

— Coffee breaks for all attendees available in the exhibit area are designed to draw participants in and keep them circulating.

— One full complimentary conference registration available with each standard price booth area will allow you to attend conference sessions and functions to interact with attendees outside of the exhibit area and gain information on OMPT and how your product or service can be of benefit to the physical therapists, researchers and fellows in the OMPT community.

Past exhibitors include companies and academic institutions providing products or services to the OMPT community.

Booth Area Rental:— Standard Booth 10’x10’ area, $750.00 — Educational Booth* Table Top Space, $400.00

Booth Area Rental Includes:— One 10’x10’ Booth Space — One Conference Registration (with Standard Booth)— One Six Foot (6’) Draped Table — Two Chairs

* Available to organizations/educational institutions offering Residency/Fellowship or DPT programs.

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FLOOR PLAN

Thursday, October 2711:00 am – 5:00 pm

Exhibit Set Up

7:00 pm – 9:30 pm Exhibits Open – Welcome Reception in the Exhibit Hall

Friday, October 287:00 am – 7:30 pm

Exhibits Open

7:00 am – 8:00 am NEW Continental Breakfast with Exhibitors

9:30 am – 10:15 amExtended Time

Coffee Break with Exhibitors

2:45 pm – 3:30 pmExtended Time

Coffee Break with Exhibitors

6:00 pm – 7:30 pm Poster Presentations and Student Meet and Greet Reception with Exhibitors

Exhibits are located in the South Exhibit Hall Disneyland® Hotel1150 Magic WayAnaheim, California 92802

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FOOD & BEVERAGE

ANAHEIM , CALIFORNIADISNEYLAND HOTEL CONVENTION CENTER - DISNEYLAND SOUTH EXHIBIT HALL

OCTOBER 26-29, 2011AMERICAN ACADEMY OF ORTHOPAEDIC MANUAL PHYSICAL THERAPISTS

ENTRANCE TOMEETING ROOMS

ENTRANCE

FOOD & BEVERAGE

ENTRANCE TO MEETING ROOMS

ENTRANCE

AAOMPT 2011 ANNUAL CONFERENCE

Physical Therapy, the Frontline of Musculoskeletal Care

Saturday, October 297:00 am – 3:00 pm

Exhibits Open

7:15 am – 8:15 am NEW Continental Breakfast with Exhibitors

10:00 am – 10:30 am Coffee Break with Exhibitors

2:30 pm – 3:00 pm Coffee Break with Exhibitors

3:00 pm – 6:00 pm Exhibits Dismantle

The exhibit schedule is tentative and may be subject to change.

EXHIBIT HOURS

The 2011 AAOMPT Annual Conference

is the national conference where persons

having a common interest in orthopaedic

manual physical therapy (OMPT) may meet,

confer and promote research, practice, and

patient care.

Be a part of this important conference

by taking advantage of the numerous

opportunities to showcase your company to

the leaders in OMPT today.

EXHIBIT SPACE APPLICATION/CONTRACT

RETURN YOUR SIGNED APPLICATION/CONTRACT AND FULL PAYMENT TO:

AAOMPT 2011 Annual Conference12100 Sunset Hills Road | Suite 130Reston, VA 20190-3221

OR fax with credit card payment to: 703.435.4390

For additional Information please contact: — Cate Langley at 703.234.4095 or

clangley@drohanmgmt.com— Pam Owens at 703-435-4121 or

powens@drohanmgmt.com

ACCOUNT NUMBER

DATE RECEIVED

AMOUNT/CHECK NUMBER

BOOTH NUMBER

BOOTH TYPE q Standard q Educational

BOOTH COST

ASSIGNMENT DATE

SENT TO LB

BATCH #

ACCEPTED BY

Agreement | Exhibitor agrees to abide by the Exhibitor Terms and Conditions as specified by the AAOMPT Conference and in the online Exhibitor Service Kit. I certify that my company is not an environment where financial incentives are provided for patient referrals.

PRINTED NAME

SIGNATURE DATE

TITLE

Confirmation will be sent to you with final assigned space upon receipt of full payment. Acceptance of an application to exhibit does not constitute endorsement of your product/service by AAOMPT or other supporters of the conference.

AAOMPT USE ONLY

Exhibitor Information

COMPANY/ORGANIZATION NAME

MAILING ADDRESS

CITY STATE ZIP

WEBSITE

Contact Information | (Only the official contact will receive all exhibit-related materials.)

NAME PHONE

FAX EMAIL

Product Description | (50 words or less – for official listing in Conference Program, etc.)

2011 Booth Rates | Standard (10’ x 10’) $750 | Educational $400*Booth Selection | Exhibitor understands that the preferences in display areas may not be available and that Conference Management may assign alternate areas of similar size. (see Exhibitor Terms & Conditions as specified by the AAOMPT Conference and in the online Exhibitor Service Kit.) Please list three choices.

Booth Numbers Booth Type No. of Booths Cost

1st q Standard q Educational

2nd q Standard q Educational

3rd q Standard q Educational

NOTE: Standard Booth rates include one full complimentary conference registration. *Educational spaces apply only to qualified organizations that offer information on Residency, Fellowship and DPT programs.

Complimentary Registration | Name of person receiving full complimentary registration

NAME TITLE

Special Requirements | q Check here if any personnel in attendance will need special services or accommodation.

PLEASE SPECIFY

Payment Information | This application must be received with full amount due. Space will not be assigned/confirmed without payment. Full Amount $

q Check (made payable to AAOMPT) q American Express q MasterCard q Visa

CARD NUMBER EXP. DATE

CARDHOLDER’S NAME (PLEASE PRINT)

CARDHOLDER’S SIGNATURE

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ACCOUNT NUMBER

DATE RECEIVED

AMOUNT/CHECK NUMBER

BOOTH NUMBER

BOOTH TYPE q Standard q Educational

BOOTH COST

ASSIGNMENT DATE

SENT TO LB

BATCH #

ACCEPTED BY

PurposeThe purpose of the AAOMPT exhibit is to complement the program sessions by informing and educating physical therapists about the latest developments of products and services in this field.

The name “AAOMPT” when used herein or in subsequent material shall mean the American Academy of Orthopaedic Manual Physical Therapists, its committees, agents or employees acting for the management of the conference.

Exhibit CriteriaExhibiting firms and companies will be limited to those providing services, products or pub-lications, which are directly applicable to the field of physical therapy. AAOMPT reserves the right to decline any exhibit application or to require any exhibitor to remove an exhibit or any part of an exhibit which, in the sole judgment of AAOMPT, is misleading or deceptive, in poor taste, or unsuitable to or not in keeping with the charter and objectives of the Conference.

Assignment of Booth Space and Floor PlanAll applications will be date stamped upon receipt. Exhibit space will be assigned on a first-come, first-served basis, according to the date the application and payment is received. AAOMPT reserves the right to make the allocation of exhibit space or to change the space allocation at any time based on space availability or other considerations in the overall interest of the exhibit. The failure to allocate to an Exhibitor its requested space will not in any way affect the enforceability of this Agreement. The floor plan submitted is believed to be gener-ally accurate, but AAOMPT makes no warranties or representations with respect to actual measurements.

Cancellation by ExhibitorAAOMPT will refund 50% of the space rental charge for cancellations received on or before August 1, 2011. Cancellations received August 2, 2011 or later will forfeit 100% of the space rental charge to AAOMPT. AAOMPT reserves the right to occupy, resell said space to another exhibitor without any rebate or allowance to the canceling Exhibitor except as provided above. All cancellations of exhibit space must be submitted in writing and will be applied on the date of receipt.

Contractor ServicesThe AAOMPT Official Service Contractor shall prepare and distribute to Exhibitors an Exhibitor Service Kit containing general and technical information regarding the Exposition, instructions, rules, regulations, order forms and other pertinent information prior to the Show’s commence-ment date.

Exhibitor’s RepresentativeEach Exhibitor must identify one representative to have charge of the Exhibit, and who hereby accepts and assumes responsibility for such representatives, or alternatives, being in attendance at its exhibit throughout exhibit periods.

Exhibit DimensionsExhibit booths are not to exceed 10 feet in depth, 8 feet in height, and 10 feet in width. Side rail dividers that are 8 feet high may not extend more than 3 feet forward from the back wall of the booth so as not to obstruct the view of other exhibits. If constructed dis-play fails to meet the requirements, AAOMPT reserves the right to authorize removal or relocation of the display.

Installation/DismantleAll booths must be fully installed prior to the official opening time of the exhibit as specified by AAOMPT. Exhibitors may not dismantle their booth or pack any portion of their exhibit prior to the official closing hour of the exhibit. Delivery or removal of any part of an exhibit is prohibited during official show hours unless prior consent has been given by AAOMPT.

Failure To Occupy SpaceAny space not occupied within the allocated set up time as specified by AAOMPT will be forfeited by the Exhibitor, and that space may be resold, reassigned or otherwise used by AAOMPT without refund of rental price, unless arrangements for delayed occupancy have received prior written approval by AAOMPT.

Special RestrictionsCirculars, advertising materials, etc. may be distributed, and patronage solicited only within the space assigned to the Exhibitor presenting the material. Exhibit space may not be occupied by or sublet to any firm other than the firm which originally contract-ed for said space. Exhibitors are prohibited from using amplifying equipment of any nature without permission from AAOMPT; if permission is granted, the use of such equipment must not interfere with adjacent exhibits or other activities in the exhibit hall. If the premises are defaced or damaged by an act of negligence by any Exhibitor, its agents or guests, the Exhibitor will pay the sum deemed necessary for complete restoration to previous conditions.

EXHIBITOR CONTRACTRULES & REGULATIONSAAOMPT 2011 Annual Conference

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Copyright IndemnificationThe Exhibitor is responsible to secure permission from copyright holders for the use of any copyrighted materials (including but not limited to printed matter, music, video and software) during the Exposition. Exhibitor must provide proof of said certification or licensing. The Exhibitor agrees to indemnify, defend and hold harmless AAOMPT from and against any and all demands, claims, suits, cause or causes of action, whether at law or in equity costs, expenses and attorney’s fees and any liability to AAOMPT arising from improper use of copy-righted matter during Exposition hours.

Exhibit Design RegulationsPlease read carefully the accompanying Booth Design Rules and Regulations for design and setup for displays at the AAOMPT Annual Conference and Exhibition. AAOMPT has adopted these rules and regulations from the International Association of Exhibitions and Events (IAEE).

Hospitality EventsExhibitor agrees that hosting social events, sales meetings, client presentations, etc. during official conference program hours and in an area outside of the official exhibit space assigned to the exhibitor is detrimental to the overall conference, the other exhibiting companies and attendees. For this reason, exhibitors are prohibited from hosting conflicting events during of-ficial conference program hours. Hospitality functions may be sponsored and/or hosted during approved times and dates set by AAOMPT. Hospitality events sponsored/hosted by exhibiting companies must be approved by AAOMPT. Marketing materials/invitations issued by the exhib-iting company related to approved hospitality events must be approved by AAOMPT.

Liability and SecurityEach Exhibitor must make provisions for the safeguarding of his/her goods, materials, equip-ment, and display at all times. AAOMPT expressly disavows any responsibility for any theft or other damage occasioned by the negligence of such security personnel. AAOMPT strongly recommends that each exhibiting company secure a rider policy through its insurance agent to cover all booths and display items during transportation to and from this conference as well as during installation, exhibit days, and dismantling. Neither AAOMPT, the employees thereof, nor the officers, agents, and contractors, the service contractors, the employees thereof, nor any member of AAOMPT conference planning committee, nor the Host. Facility will be responsible for any injury, loss, or damage that may occur to the exhibit or the Exhibitor’s employees or property, prior, during, or subsequent to the period covered by the exhibit contract, provided said injury, loss, or damage is not caused by the gross negligence or willful misconduct of one or more the aforementioned parties. The Exhibitor expressly releases the foregoing names, associations, individuals, committee and firms from any agreement to indemnify it against any and all claims for such loss, damage, or injury. It is expressly agreed that neither AAOMPT, nor the service contractor, nor the Host Facility shall be held liable or accountable for any losses, damages, or injuries which may be sustained or incurred by any person whomsoever, who may be on the premises leased by or assigned to any Exhibitor, including (but not limited to) any agent, employee, or representative of any Exhibitor. The Exhibitor expressly agrees that he/she will hold, keep, save harmless, and indemnify AAOMPT and the service contractor from any and all such claims. The Exhibitor agrees to defend, indemnify and hold harmless AAOMPT, the Host Facility, its owners, managers, officers or directors, agents, employees, subsidiaries and affiliates from any damage or charges resulting from Exhibitor’s use of prop-

erty. Exhibitor’s liability shall include losses, costs, damages, or expenses arising from or out of or by reason of any accident or bodily injury or other occurrences to any person or persons, including the Exhibitor, its agents, employees and business invitees which arise from or out of the Exhibitor’s occupancy and use of the exhibition premises, the Hotel or any part thereof. Exhibitor shall be fully responsible to pay for any and all damages to property owned by the Host Facility, its own-ers or managers that results from any act or omission of Exhibitor.

InsuranceEach Exhibitor is required to insure itself against property loss or damage and against liability for personal injury. Proof of a Certificate of Liability Insurance covering the exhibitor for a minimum of one million dollars ($1,000,000) MUST be made available to AAOMPT upon request.

American with Disabilities Act ComplianceThe Exhibitor agrees to comply with ADA guidelines in ensuring their booth is safe and accessible to persons with disabilities. Reasonable accommodations include but are not limited to: wheelchair access into the booth including proper ramping to raised platforms; listening systems for hearing disabled persons; no architectural barriers or protruding objects dangerous to visu-ally disabled persons; display counter or touch screen display heights accessible to disabled persons. AAOMPT reserves the right to require ADA non-compliant exhibitors to modify their booth where readily achievable and technically feasible.

Hotel ReservationsHotel accommodations have been arranged by AAOMPT for exhibitors at a special Conference rate. Call the Host Hotel directly and refer to the AAOMPT Conference to make hotel reservations.

On-The-Floor SalesExhibitors are encouraged to offer informa-tion that is educational, professional and in-structional. Exhibitors who sell merchandise are responsible for obtaining any state, and/or local sales tax permits, if required, and for paying the resulting tax on gross sales as required by law.

AAOMPT 2011 ANNUAL CONFERENCE

Physical Therapy, the Frontline of Musculoskeletal Care

OCTOBER 26-30, 2011DISNEYLAND® HOTEL | ANAHEIM, CA

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Cancellation of ExpositionShould any situation beyond the control of AAOMPT arise to prevent the Exposi-tion from being held, either in whole or in part, AAOMPT will not be held liable for any expenses incurred by the exhibitor except the fee for rental booth space less a proportionate share of expenses incurred and committed by AAOMPT. Such situations include but are not limited to destruction or damage of the exhibit hall, or strike, lockout, emergency, injunction, act of God, act of war, act or threat of terrorism, or any other cause beyond the control of AAOMPT.

ViolationsViolations of any of these regulations or pre-vailing laws on the part of the exhibitor, his/her employees, or agents shall, at the option of AAOMPT, annul the right to occupy space and such an Exhibitor will forfeit to AAOMPT all monies paid. AAOMPT may re-enter and take possession of the space occupied by the Exhibitor and remove all persons and goods at the Exhibitor’s risk and Exhibitor shall pay all such expenses and all damages which AAOMPT may incur, and forfeit all monies paid or due to AAOMPT on account thereof. The exhibitor waives any right to written notice from AAOMPT of its intention to terminate this agreement and repossess space occupied by the Exhibitor by reason of such violation.

AmendmentsAAOMPT may at any time amend these terms and conditions and documents included herein by reference and each exhibitor shall be bound thereby. In the event of any amend-ments or additions to these regulations, written notice will be given by AAOMPT to such exhibitors as may be affected by them. In addition, AAOMPT may post or publish notice of such amendments as it may think appropriate or find practical.

Exhibit Contract and PoliciesThe AAOMPT reserves the right to render all interpretations and decisions, should any question arise, and to establish further regulations as may be deemed necessary to the general success and well being of the Conference. All matters and questions not covered in these policies are subject to the final judgment and decision of AAOMPT.

DISPLAY RULES AND REGULATIONS

Thank you for your support of

AAOMPT and this Exposition.

The following Booth Design Rules and Regulations have been

developed to assist in effectively administering the exposition and

to promote continuity in exhibit design and setup for displays at the

AAOMPT Annual Conference. All Exhibitors are considered equal

regardless of size and are given equal opportunity, within reason, to

present their product in the most effective manner to the audience.

Exhibit Management has adopted the following booth dimension rules

and regulations from the International Association of Exhibitions and

Events (IAEE) in an effort to make this possible while still allowing the

greatest flexibility in the overall exhibit. Exhibits will be so arranged as

not to obstruct the general view, nor hide the exhibits of others.

Display Regulations

Line of SightSigns, displays, products, and fixtures for all exhibit configurations located within an area 5 feet from the aisle and 10 feet from a neighboring exhibit can be no more than 4 feet high.

Types of Booths

Linear BoothLinear Booths have only one side exposed to an aisle arranged in a series along a straight line. They are also called “in-line” booths. Linear Booths are 10 feet wide and 10 feet deep, i.e. 10 feet by 10 feet. A maximum back wall height limitation is 8 feet. Regardless of the number of Linear Booths utilized, display materials should be arranged in such a manner so as not to obstruct sight lines of neighboring exhibitors. The maximum height of 8 feet is allowed only in the rear half of the booth space, with a 4 foot height restriction imposed on all materials in the remaining space forward to the aisle. Note: When three or more Linear Booths are used in combination as a single exhibit space, the 4 foot height limitation is applied only to that portion of exhibit space which is within 10 feet of an adjoining booth.

Corner BoothA Corner Booth is a Linear Booth exposed to aisles on two sides. All other guidelines for Linear Booths apply.

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Individual Sponsorship ItemsThe following items/events are avail-able for individual sponsorships.

$2,500 | Badge LanyardsThe cotton or synthetic badge lanyard will include your company logo screened on the lanyard. Attendees will thank you for the comfort of wearing their badge to all confer-ence events.

$500 | Conference Material Insert*

One-page insert, or one item, to be included in conference materials provided to attendee onsite.

* Appropriate quantity of one page insert or item

to be provided by sponsoring company

All AAOMPT 2011 Annual Conference Sponsors Receive:— Acknowledgement in onsite conference program

by contribution level including company logo

— Prominent signage at the conference

— Sponsor ribbons on name badges of all sponsoring company attendees

— Logo and link to sponsor site on AAOMPT conference website

— Contact mailing information, after conference, of all attendees

General SponsorshipThe following general sponsorship opportunities will provide your company exposure to AAOMPT members before the conference, at the conference, and after the conference. In addition to the overall sponsorship exposure, we have added new dimensions to these general sponsorship opportunities to enable you to reach the AAOMPT members like never before!

Gold $5,000 | Also Receive:— One (1) full complimentary conference registration— One (1) 10’x10’ exhibit booth at the conference— One (1) one-page insert, or one item, to be included in conference materials provided to

attendees onsite*— Logo and link to your website on the AAOMPT conference website home page— One (1) full-page advertisement in the conference onsite program— One (1) full-page advertisement in Articulations (AAOMPT’s quarterly online eNewsletter)— One (1) one-page educational article in Articulations

Silver $3,500 | Also Receive:— One (1) full complimentary conference registration— One (1) half-page advertisement in the conference onsite program— One (1) half-page advertisement in Articulations (AAOMPT’s quarterly online eNewsletter)— Logo and link to your website on the AAOMPT conference website home page

Bronze $2,000 | Also Receive:— One (1) full conference registration at 50 percent discount— One (1) quarter-page advertisement in the conference onsite program— One (1) quarter-page advertisement in Articulations (AAOMPT’s quarterly online eNewsletter)— Logo and link to your website on the AAOMPT conference website home page

CONFERENCE SPONSORSHIP OPPORTUNITIES

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NETWORKING EVENTSThe perfect way to show your support of AAOMPT and publicize your organization to all registrants of the conference, sponsor one of the networking functions during the conference.

Sponsors in this category can place their product literature on the food and beverage tables as appropriate with décor and food displays. Choose to be an exclusive sponsor or share the limelight with other contributors.

Thursday, October 27Fellowship Recognition and Welcome Reception$5,000/$1,250

This reception will recognize all AAOMPT members who have achieved the distinction of Fellow during the last year. All conference attendees are invited to the recognition ceremony followed by the welcome reception.— One exclusive sponsorship for $5,000 or four shared sponsorships at $1,250 each

Friday, October 28 or Saturday, October 9Morning Refreshment Break$1,000/$250— One exclusive sponsorship for $1,000 or four shared sponsorships at $250 each

Friday, October 28AAOMPT Awards Luncheon$6,000/$1,500The AAOMPT Luncheon and AAOMPT Member Awards Program recognizes the achieve-ments and leaders of the AAOMPT community during the past year.— One exclusive sponsorship for $6,000 or four shared sponsorships at $1,500 each

Friday, October 28 or Saturday, October 9Afternoon Coffee Breaks$1,000/$250— One exclusive sponsorship for $1,000 or four shared sponsorships at $250 each

Friday, October 28Poster Presentations and Student Meet and Greet Wine and Cheese Reception$3,000/$750This reception will highlight the 2011 poster presentations and host a student meet and greet. Held in the Exhibit Area this event will provide attendees, presenters and exhibitors a chance to interact, exchange information and network all in one location.

— One exclusive sponsorship for $3,000 or four shared sponsorships at $750 each

Saturday, October 29Saturday Night Reception$7,500/$2,000This will be the perfect evening to relax and have some fun. All conference attendees are invited to this reception and will dance the night away all the while thanking your company for making this possible.

— One exclusive sponsorship for $7,500 or four shared sponsorships at $2,000 each

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CONFERENCE ADVERTISING OPPORTUNITIES

Conference Program Guide/Articulations Rates

Don’t miss out on this great opportunity to increase your vis-ibility within the industry at great rates! Any vendor that pur-chases ad space in the 2010 AAOMPT conference onsite program is eligible for significantly reduced ad rates in Articu-lations, AAOMPT’s highly-praised quarterly online eNewsletter. Advertising in the pre-conference and post-conference issue of the newsletter will increase your visibility by 200 percent more than by just advertising in the conference program.

AAOMPT’s quarterly online eNewsletter is received by 1,800 individuals, physical therapy schools, ortho-paedic study groups, and members of orthopaedic manual therapy groups in Canada.

Take advantage of these great rates!

Ad SizeConference Program

Articulations Normally

Articulations Special Rates for Conference Program Advertisers (electronic ad only)

Full Page $ 550 $ 400 per quarter $ 275 per quarter

Half Page $ 275 $ 300 per quarter $ 200 per quarter

Quarter Page $ 125 $ 200 per quarter $ 150 per quarter

Back Cover $ 650

Inside Front ORInside Back Cover

$ 600

AAOMPT 2011 ANNUAL CONFERENCE

Physical Therapy, the Frontline of Musculoskeletal Care

OCTOBER 26-30, 2011DISNEYLAND® HOTEL | ANAHEIM, CA

11

SponsorshipsGeneral:q $5,000 – Gold q $3,500 – Silverq $2,000 – Bronze

Individual Itemsq $2,500 – Badge Lanyards q $500 – Conference Material

Insert

AdvertisingConference Program Ads:Deadline: August 25, 2011q Full Page – $550q Half Page – $275

q Quarter Page – $125q Back Cover – $650q Inside Front or Inside Back Cover –

$600

Articulations Ads:q Full Page – $275/Quarterq Half Page – $200/Quarterq Quarter Page – $150/Quarter

Please Specify Articulations Quarter:q October/November/December 2011q January/February/March 2012q April/May/June 2012q July/August/September 2012

Networking EventsReception Thursday, October 27q $5,000 q $1,250

Morning Break Friday, October 28q $1,000 q $250

Awards Lunch Friday, October 28q $6,000 q $1,500

Afternoon Break Friday October 28q $1,000 q $250

Poster Presentation Meet and Greet Friday, October 28q $3,000 q $750

Morning Break Saturday, October 29q $1,000 q $250

Afternoon Break Saturday, October 29q $1,000 q $250

Networking ReceptionSaturday, October 29q $7,500 q $2,000

Return Your Completed Conference Sponsorship Reservation Form With Payment To:

AAOMPT 2011 Annual Conference12100 Sunset Hills Road | Suite 130Reston, VA 20190-3221

OR fax with credit card payment to: 703.435.4390

Sponsorship, advertising and promotional opportunities are assigned based on availability.

For questions or more information about sponsorships and advetising opportunities at the 2011 AAOMPT Annual Conference, please contact:— Cate Langley at 703.234.4095 or

clangley@drohanmgmt.com— Pam Owens at 703-435-4121 or

powens@drohanmgmt.com

ACCOUNT NUMBER DATE RECEIVED

AMOUNT/CHECK NUMBER BATCH # ACCEPTED BY

AAOMPT USE ONLY

CONFERENCE SPONSORSHIP & ADVERTISING RESERVATION FORM

Payment Information Full Amount $q Check (made payable to AAOMPT) q American Express q MasterCard q Visa

CARD NUMBER EXP. DATE

CARDHOLDER’S NAME (PLEASE PRINT)

CARDHOLDER’S SIGNATURE DATE

Sponsoring Organization or Practice (type or print clearly exactly how you wish infor to appear in print)

ORGANIZATION NAME

CONTACT NAME

TITLE

ADDRESS

CITY STATE ZIP

PHONE FAX

EMAIL

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2011 ANNUAL CONFERENCEPhysical Therapy, the Frontline of Musculoskeletal Care

OCTOBER 26-30, 2011 | DISNEYLAND® HOTEL | ANAHEIM, CALIFORNIA

©Disney

AAOMPT 2011 Annual Conference12100 Sunset Hills Road | Suite 130Reston, VA 20190-3221