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2024 Imaging Showcase and Fredric Fay Lecture Participation Form

Please complete the form below by selecting the supporter levels. Include all contact information.

Please contact us at SCOPE@umassmed.edu with any questions.

Email Address for primary contact: *

Company Name (as it should appear in the program): *

Contact Name for all sponsorship activities: *

Billing Contact Email: *

Contact Phone Number: *

Supporter levels * Lecture Reception - $6,000 Double Tabletop Exhibit - $5,000 Single Tabletop Exhibit - $3,000 Half Day Table - $1500 Fredric Fay Breakfast for Postdocs - $500 Fredric Fay Lunch for students - $500

Summary of Support Commitment: *

Comments: