SUBMIT PRODUCT DEMO The Product Demos sessions available for the MD Expo event are an opportunity for a company to demonstrate its product or services to registered attendees. The cost is $4,250 to reserve a 60-minute session. Since space is limited, please confirm availability before completing this form. Your Name* First Last Company* Job Title* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* PhonePlease provide a recent headshotMax. file size: 200 MB.Education, Certifications, Credentials, and Work Experience:* I will upload my Curriculum Vitae or resumé, which will include this information. I will enter my information on this form. Upload CV or Resumé FileMax. file size: 200 MB.Please upload either a Word document or PDF.Education (May submit curriculum vitae or resumé.)If choosing to submit required information via uploaded file, please indicate "n/a" in the text box below.Certifications/CredentialsPractice/Work ExperienceProposed Presentation InformationProduct Demo Title* Objectives (What will the participant learn as a result of this activity?)*Outline or description of activity content*Permission to record presentation? Yes No Educational presentations will occur during 1-hour and 15-minute time slots. By presenting this proposal for a presentation you agree that you are available to present at the event on either day.* I acknowledge that I have read and agree to the terms of the submission process.