SBAS 2026 Exhibit Application – Society of Black Academic Surgeons

SBAS Invites you to register as an exhibitor for the 2026 Scientific Meeting. The Exhibitor Prospectus includes full exhibit level benefits and information. For questions or assistance, please contact Sara Rossi Statis at sara@sbas.net.

Exhibitor Application

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Organization Information

Organization Name (as you want it to appear in the program)*

Organization Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

General Company Phone

General Email

Website*

Contact Information

Exhibit Contact Name*

First Last

Exhibit Contact Title

Exhibit Contact Phone*

Exhibit Contact Email*

Exhibit Level Reservation and Payment Options

See the 2026 SBAS Exhibitor Prospectus for level benefits.

Please select your SBAS Exhibit Level.*

Method of Payment*

Credit Card

Check

Total Due Now

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Exhibitor Agreement*

Submission of this application indicates that you understand and agree to comply with all the policies, rules, regulations, terms, and conditions contained in the Exhibitor Prospectus, and will abide by the payment schedule as outlined above, and have read the rules and agree to distribute them to those involved with your booth.