Annual Meeting Exhibitor Registration

The exhibitor registration form and payment must be received by August 1, 2023. If paying by check, please make payable to the Wisconsin Society of Anesthesiologists (or WSA) and send to:

Wisconsin Society of Anesthesiologists (WSA)
6737 W Washington St, Ste 4210
Milwaukee, Wisconsin 53214

Please complete your online registration below. Should you have any questions, please contact the WSA office by phone at 414-389-8616 or by email at info@thewsa.org.

By submitting an exhibitor registration form you agree to the following:

• The fee being paid will be used for exhibit or display fees only. No funds will be paid to support any educational programming or activities associated with the event.
• You will pay these fees without any expectation that your products or services will be purchased and without pressure to prescribe or purchase your products.
• This agreement may be terminated at any time, upon providing 30 days written notice, by either party.

I agree to the statement above. *	Yes, I agree
Company Name: *
Contact Name: *
Contact E-mail (to receive confirmation): *
Contact Phone: *
Attendee Name 1 Staffing Tabletop (1): *
Attendee Name 2 Staffing Tabletop (1):
Address: *
City/State/Zip: *
Phone: *
E-mail: *
Company Description *
Company Logo *
Company Website *
Special Needs (i.e. electricity):
Direct Competitors:
Today's Date *
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