Technology Showcase Application

To participate in the Fellows at CARVE Technology Showcase, January 29-31, 2023, please complete and submit this form, along with payment.

Step 1: Exhibitor Contact Information

Enter information as you wish it to appear in the conference materials.

Contact name

First Last

Organization

Division/Department

Address

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

Phone

Fax

Email

Website

Step 2: Technology Showcase Level

Exhibitor Level

Gold ($20,000)

Silver ($15,000)

Bronze ($10,000)

Step 3: Attendee Information

Please list names and email addresses of representatives likely in attendance at Fellows at CARVE.

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Name

First Last

Email

Step 4: Payment

Payment for selected Technology Showcase Level may be paid with check payable to Minneapolis Radiology and Vascular Research Foundation and mailed to: Minneapolis Radiology and Vascular Research Foundation Attn: Joan Stone 2955 Xenium Lane, Suite 40 Plymouth, MN 55441 Phone: 763-398-2208 / Fax: 763-398-6543 Email: jstone@mplsrad.com