Physicians Group & Residency Event Space Request

Meeting/Function

Name of Meeting/Function

Day of Week

Date

Start Time

Start Time ranges from 6:00 am - 11:00 pm

Ending Time

Ending Time ranges from 6:00 am - 11:00 pm

Attendance

List in program and attendee’s schedule?

Seating Set-Up

Seating Set-Up Type

Please briefly explain set-up needed to assist in meeting space allocation

Food & Beverage

Type of Food & Beverage: Please check the type of service, if applicable. The caterer will work directly with you after ACEP assigns space. You will be responsible for working directly with the facility on all meeting planning arrangements once space is assigned by ACEP.

Dinner Type

Reception Type

Meeting Fees*

Meeting Fee Structure*: Payment will not be processed until space is assigned.

Room for 1 to 20 People: $450
(Price after July 7: $550)

Room for 21 to 50 People: $550
(Price after July 7: $650)

Room for 51 to 200 People: $800
(Price after July 7: $950)

Room for More Than 200 People: $1,050
(Price after July 7: $1,150)

*Fees are for meeting space only and does not include food and beverage.

I acknowledge that my meeting is subject to the aforementioned blackout dates and fees. ACEP reserves the right to make changes to space assignments at any time as necessary for official conference programming (Select I Agree).

Select "I Agree"

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