25th Annual Downeast Ophthalmology Symposium & Flynn LectureSeptember 25-27, 2026 | Harborside Hotel, Spa & Marina | Bar Harbor, MESPONSOR/EXHIBITOR REGISTRATION It is essential that your company name be listed here exactly as you wish it to appear in official publications. Company Name(Required)Website(Required)Company Address(Required) Street Address Address Line 2 City State ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Contact Person(Required) First Last Phone(Required)Email(Required) Company LogoPlease upload your organization logo here. Drop files here or Select files Max. file size: 20 MB. Company DescriptionPlease use this area to include your company description within a 100 word limit. If you are an enhanced exhibitor, your limit is 200 words.Sponsorship TiersGold Sponsor: $5,000 | Exclusive Opportunity – Only 2 Available! Includes Enhanced Standard Exhibitor package (optional) with priority placement Sponsor of the buffet breakfast, including verbal recognition & inclusion of sponsorship on final agenda Premium logo placement across event materials, signage, and website (top-tier positioning) Featured recognition in pre-event email communications Full-page color insert in event meeting binder Designed for companies seeking maximum visibility and engagement with the ophthalmology community Price: Gold Sponsor Quantity01Enhanced Exhibitor Package Option Add Enhanced Exhibitor Package option Silver Sponsor: $2,500 Includes Standard Exhibitor package (optional) Logo placement across event materials, signage, and website Recognition in select pre-event attendee communications Half-page color insert in meeting binder Designed for companies seeking strong visibility and engagement with lasting value and impact Price: Silver Sponsor Quantity01Standard Exhibitor Package Option Add Exhibitor Package option Bronze Sponsor: $1,000 Logo placement in event materials, signage, and website Featured listing in printed program Recognition in select pre-event attendee communications Quarter-page color insert in event attendee program Designed for companies seeking a consistent and cost-effective presence, or those wishing to support the symposium but are unable to attend. Price: Bronze Sponsor Quantity01Interested in other sponsorship opportunities or possible alterations of the above options to better fit your needs? Please contact us to discuss – sgoggin@mainephysicians.org | 207-485-1166Exhibit Packages Exhibitor space is limited to maintain a high-quality experience and is assigned on a first-come, first-served basis.Standard Exhibit: $1,650 Quantity Exhibit table (6″ x 30″) with table cover and chairs Two exhibitor registrations Listing in meeting binder/logo on the MSEPS website Access to all exhibit hall traffic and designated breaks Breakfast provided on Saturday and Sunday Price: Standard Exhibit Quantity01Enhanced Standard Exhibit: $2,000 (Best Value) QuantityIncludes all Standard benefits, plus: Priority table placement 2 tickets to the Saturday afternoon lunch buffet Featured listing in event communications Price: Enhanced Standard Exhibit Quantity01Double Exhibit: $3,100 Quantity Two Exhibit tables (6′ x 30″) with table covers and chairs Four exhibitor registrations Listing in meeting binder/logo on the MSEPS website Access to all exhibit hall traffic and designated breaks Breakfast provided on Saturday and Sunday Price: Double Exhibit Quantity01Enhanced Double Exhibit: $3,450 (Best Value) QuantityIncludes all Double benefits, plus: Priority table placement 4 tickets to the Saturday lunch buffet Featured listing in event communications Price: Enhanced Double Exhibit Quantity01Representative(s) Attending Symposium Information below will be used for name badges & attendance lists. Guest Name is for Friday evening activities (extra charge). Friday evening activities are not included in exhibit registration fee (extra charge handled separately). Representative 1 Name First Last Representative 1 Email Representative 1 PhoneRepresentative 1 Guest NameRepresentative 2 Name First Last Representative 2 Email Representative 2 PhoneRepresentative 2 Guest NameRepresentative 3 Name First Last Representative 3 Email Representative 3 PhoneRepresentative 3 Guest NameRepresentative 4 Name First Last Representative 4 Email Representative 4 PhoneRepresentative 4 Guest NameElectrical Requirements(Required)Extension cords must be provided by each individual exhibitor I do not require electrical power I do require electrical power Will you have a Tabletop Banner/Tall Display?(Required) Yes No Will you have a Floor Banner(s)?(Required) Yes No Will you have floor equipment?(Required) Yes No Companies you would prefer not to be located next to (if possible):(Required)List companies in case they are exhibiting. If no preference, please indicate “no preference.”Total Payment will be made by:(Required) Check Ck# Credit Card Make checks payable to: Downeast Ophthalmology Symposium P.O. Box 190, Manchester, ME 04351 sgoggin@mainephysicians.orgPayment MethodPayPal CheckoutCredit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Participation in Friday evening events will be handled separately. By registering as an exhibitor or sponsor, you grant the Maine Society of Eye Physicians and Surgeons (MSEPS) permission to use photographs and videos taken during the event for promotional purposes. You also grant permission for MSEPS to use the logo provided through this registration form in event-related materials, including but not limited to the MSEPS website, event signage, slideshows, printed materials, and marketing communications. No exhibit registrations will be finalized without payment. Cancellations prior to August 25th will be subject to a $250.00 administrative fee. No refunds of exhibit fees will be granted after August 25, 2026. Please contact Shirley Goggin with any questions: sgoggin@mainephysicians.org or 207-445-2260
