Registrant List Order and Agreement

Indicates required field

To process your Registrant List Order you must submit a sample mailing piece for approval and full payment at the time of your request.

Company Name

Contact Name

E-Mail Address

Select one:

Exhibit Hall/Sponsorship ($550 per one-time use)

Symposia (included with paid administrative fee)

Innovation Theater/Sponsorship (included with paid sponsorship fee)

Label Sequence:

Alpha

ZIP Code

Alpha U.S. Only

ZIP Code U.S. Only

List Timing:

Early Pre Registrant List

Late Pre Registrant List

Post Registrant List (available after the meeting)

Sample Mailer:

Do not print your mailing piece before receiving approval by ACP.
If ordering 2 lists with different mailers, or mailers with different sequences/timing, please submit as separate orders. Fees for additional orders will apply.
Unlimited number of files can be uploaded to this field.
20 MB limit.
Allowed types: pdf, doc, docx.

Only mailing addresses are available for rental. Telephone numbers and e-mail addresses are not available for rental. The ACP Registrant List is available for direct mail purposes only; it cannot be used for telemarketing or e-mail marketing purposes.

Agreement:

We/I am authorized to enter into this agreement. By submitting this agreement, I am indicating that I have read and agree to abide by the Internal Medicine Meeting Terms and Conditions & List Use Policy and terms noted below.

Internal Medicine Meeting (IMM) lists are for one-time use only. Renters will be billed for any subsequent unauthorized use.

I agree that the one-time list will be used solely for the approved mailer. The names and addresses provided by ACP may be used only for the approved mailer and must not be used for any other communication or outreach of any kind, including email, phone, or digital.

Upon completion of the mailing, I agree to destroy the ACP-provided list and make no further use of the names and addresses, except for those obtained directly from individuals who respond to the mailing.

For paid list requests, an invoice will be emailed. The invoice must be paid prior to receiving the attendee list.

Any questions prior to submission may be directed to Stefy Beury at 215-351-2541or sbeury@acponline.org.

If you wish to keep a copy, please print prior to submission.