Welcome [app.idph.state.il.us]app.idph.state.il.us/docs/FINAL2011OWH_Registration.pdf · The four...

Welcome

On behalf of the Illinois Department of Public Health’s Office of Women’s Health (OWH), the Illinois Public Health Association and the 2011 Advisory Committee, I would like to extend an invitation to you to consider being a sponsor, exhibitor or attendee at one of the most prestigious conferences about women’s health held in Illinois.

Reaching Illinois women is at the core of every activity conducted by the OWH. The office was established in 1997 and is now one of the largest state offices of its kind in the country. The OWH serves the women and girls of Illinois in several capacities by offering:

Illinois Breast and Cervical Cancer Program – A statewide program which offers free breast and cervical cancer screenings for women between the ages of 35 and 64 who have low incomes and no health insurance. Women diagnosed with breast or cervical cancer while enrolled in the program can receive treatment benefits through the Illinois Department of Healthcare and Family Services.

WISEWOMAN Program – The WISEWOMAN (Well-Integrated Screening and Evaluation for Women Across the Nation) program is funded by the U.S. Centers for Disease Control and Prevention (CDC). The Illinois WISEWOMAN program (IWP) aims to lower heart disease and other chronic disease risk factors through screening and lifestyle classes. The four weekly lifestyle classes teach women how to eat healthy, increase physical activity, problem solve, set goals, and also teaches them about the importance of a support system.

Carolyn Adams Ticket for the Cure – Funding for this grant program is provided through the Illinois State Lottery scratch-off ticket, which funds community grant programs as well as breast cancer research grants.

In addition to our attendees being health care professionals, many are recipients of the above programs and are eager to learn about new products, medical technology and devices, pharmaceuticals, nutrition, and the latest therapies and industry advancements that may help them enhance their programs or educate their clientele. We cordially invite you to join these dynamic, influential health professionals as an exhibitor or a sponsor on November 2-3, 2011, at the Illinois Women’s Health Conference.

Don’t miss this opportunity to network with the health care professionals attending the conference. We look forward to seeing you in November!

Shannon Lightner, M.S.W., M.P.A.Deputy Director of Women’s Health

Location

Hilton Springfield Hotel700 E. Adams St.Springfield, IL 62701

A special hotel room rate of $70 is available for conference attend-ees, exhibitors and sponsors. The conference room block cut-off date is October 15, 2011. Mention that you are with the Illinois Women’s Conference when making your reservation.

Phone: 217-789-1530 or 800-HILTONSE-mail: http://www.springfieldil.hilton.com 2011 personalized Hilton Web page:http://www.hilton.com/en/hi/groups/personalized/S/SPFSHHF-IWC-20111101/index.jhtml?WT.mc_id=POG

2011 Advisory Committee Jean Becker, R.N., B.S.N., M.P.H.Illinois Department of Public Health Sharon Canariato, M.S.N., M.B.A., R.N.Illinois Nurses Association Lynne Chambers, M.S.Chambers and Associates, LLC Lesley J. CraigU.S. Department of Health and Human ServicesHIV/AIDS Regional Resource Network Program – Region V Cynthia Flayton, R.N., M.S.Oakton Community College Doris GarrettSusan G. Komen for the Cure Peoria Memorial Heather Gavras, M.P.H., R.D.American Heart Association, Midwest Affiliate Omayra Giachello, M.P.H.Illinois Department of Public Health Sharon Green, M.H.A.Institute for Women’s Health ResearchNorthwestern University Michelle Hoersch, M.S.U.S. Department of Health and Human ServicesOffice on Women’s Health – Region V Kimberly Kirchherr, M.S.Jewel-Osco/SuperValu Corporate Dietitian (Midwest Region) JoAnn LeMaster, M.S., MCHESSouthern Illinois University School of Medicine Linda Maricle, B.S.Susan G. Komen for the Cure Peoria Memorial Nomathemba Pressley, M.P.H.American Cancer Society, Illinois Division Judy Shackelford, R.N., B.S.N., M.S.N., Ph.D.Director of Continuing Education, St. Johns College Lynette Shaw, M.S .ED, CHESIllinois Department of Public Health Kris Zimmermann, M.P.H. University of Illinois at Chicago Event ChairShannon Lightner, M.S.W., M.P.A.Office of Women’ HealthIllinois Department of Public Health Event Co-ChairsBrenda BlaskoIllinois Department of Public Health Sarah O’Connor-Bennett, M.S., ED.Chief, Division of Information and EducationIllinois Department of Public Health Exhibits:Maureen JenningsIllinois Department of Public Health Continuing Education:Kristen BallIllinois Public Health Association Conference Logistics:Angie WangerIllinois Public Health Association Facility Logistics:Emily DoeringIllinois Department of Public Health Audio Visual: Mark HayesIllinois Department of Public Health

2011 Conference Agenda

Program PurposeTo learn new information related to disease prevention and management, including nutrition, latest therapies and advancements to help participants enhance their programs and educate their clientele.

Target AudienceThis program is designed for those interested in women’s issues, including health professionals who are interested in educating themselves about diseases and the effects on women’s health:

• Public health personnel and staff• College and university students• Public and private sector health professionals• Nurses• Health educators• Licensed social workers/Licensed clinical social workers• Professional counselors/Licensed clinical counselors• Dietitians• Certified health education specialist

Continuing Education Registered NursesThis activity has been submitted to WNA CEAP for approval to award contact hours. Wisconsin Nurses Association is accredited as an approver of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Social Workers/Counselors/DietitiansContinuing education credits are available from Oakton Community College, Alliance for Lifelong Learning, Continu-ing Education for Health Professionals (OCC/ALL/CEHP) for licensed social workers/licensed clinical social workers, counselors, and dietitians.

UniversalOakton Community College, Alliance for Lifelong Learning, Continuing Education for Health Professionals (OCC/ALL/CEHP ) is also providing Universal CE for other professionals. One universal training hour (UTH) from Oakton Community College is equal to one 60-minute clock hour.

Certified Health Education SpecialistsIPHA is a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing Inc. This program is a designated event for CHES to receive Category I CECH in health education.

2011 Illinois Women’s Health ConferenceWednesday, November 2, 20117:30 a.m. – 3 p.m. Registration and Conference Walking Challenge Registration

New for 2011! Join other participants and sign up for the “Conference Walk Your Way to Health Challenge.” Participants are encouraged to sign up and receive a pedometer to track their steps while in attendance at the conference. There will be a “one-day challenge” and a “two-day challenge.” Prizes will be awarded at the end of each day!

7:30 a.m. – 8:45 a.m. Deluxe Continental Breakfast

8 a.m. – 8:45 a.m. Pre-conference WorkshopsPre-conference Workshop I – Eat Smart – Live StrongAngela Hamm, M.S., Illinois Department of Public Health, SpringfieldThe United Stated Drug Administration Food and Nutrition Service developed this intervention specifically for participants 60 to 74 years old, to help nutrition education providers deliver services to a growing older adult population. The program addresses healthy nutrition and the need for participation in moderate intensity, physical activity each day. This presentation is accompanied by a free activity kit which includes all materials needed to deliver a successful program.Pre-conference Workshop II – Fresh From the Farm Part II: Planting Seeds for Future GenerationsLindsey Arenberg, M.S., Seven Generations Ahead, Chicago This program will introduce attendees to the concepts of farm to school programs, and specifically highlight the components of Fresh From the Farm. Participants will learn practical tips for successful food education programs and discuss activities to create healthier school environments.Pre-conference Workshop III – Illinois HELPS ProgramDawn Davis, R.N., B.S.N., M.S.N., APRN-BC, Illinois Department of Public Health, ChicagoIllinois HELPS Program was designed to train nurses, doctors, emergency response personnel, volunteers and other health profes-sionals who assist in disaster situations in Illinois to ensure proper standards of care are provided. The program also provides community-based organizations, local health departments and federally qualified health centers with information for preparedness of emergencies through the federal hospital bioterrorism program.Pre-conference Workshop IV – Institute of Medicine Report – The Future of Nursing: Illinois Campaign for ActionLinda Roberts, M.S.N., R.N., Illinois Department of Financial and Professional Regulation, ChicagoThe Illinois State Healthcare Action Coalition (IL HAC) is the state driving force of the Future of Nursing: Campaign for Action (CFA), a broad, national effort to drive implementation of the Institute of Medicine’s (IOM) blueprint for ensuring that all Americans have access to high quality, patient-centered care in a health care system where nurses contribute as essential partners in achieving success. IL HAC Co-chairs, the Illinois Department of Financial and Professional Regulation Center for Nursing and the Illinois Department of Commerce and Opportunity are working with partners from business, education, professional organizations, consumers, unions and foundations to transform the nursing field to prepare nurses to lead change and advance health for all Americans. 8 a.m. – 3:45 p.m. Exhibits Open

9 a.m. – 9:30 a.m. WELCOME – Damon T. Arnold, Director of Public Health, Shannon Lightner, Deputy Director, Office of Women’s Health, Gov. Pat Quinn (invited) and Lt. Gov. Sheila Simon (invited)

9:30 a.m. – 10:30 a.m. OPENING SESSION Prevention of Diseases: Cardiovascular Disease, Obesity and More Donald Lloyd-Jones, M.D., ScM, Chair, Department of Preventive Medicine, Northwestern University, Chicago

Dr. Donald Lloyd-Jones is chair of the Department of Preventive Medicine and associate professor of Medicine-Cardiology at the Northwestern University Feinberg School of Medicine. Lloyd-Jones’ interests lie in cardiovascular disease epidemiology, risk estimation and prevention. A main focus of his research has been investigation of the lifetime risks for various cardiovascular diseases, and factors which modify those risks. His clinical and teaching interests lie in general cardiology, with a focus on prevention.

10:30 a.m. – 11 a.m. Health Information Break – Visit Exhibits

11 a.m. – Noon Concurrent Workshops – Session A Workshop 1 Women, Girls and Skin Cancer Lucinda Buescher, M.D., Southern Illinois University School of Medicine, Springfield Workshop 2 Endocrine Disruptors: The Environment and Other Culprits Susan Buchanan, M.D., University of Illinois at ChicagoWorkshop 3 Rheumatoid Disorders and Diseases Anne Miller, M.D., Southern Illinois University School of Medicine, Springfield

2011 Conference Agenda 2011 Conference Agenda

Noon – 1:15 p.m. Luncheon and Healthy Cooking With Lindsey Lindsey Arenberg, M.S., LeCordon Bleu Baking and Pastry Chef, Chicago

1:15 p.m. – 2:15 p.m. Concurrent Workshops – Session BWorkshop 4 Obesity and Cancer Laura Rogers, M.D., Southern Illinois University School of Medicine, SpringfieldWorkshop 5 The Food – Health Connection Michelle Couri, M.D., Couri Center for Gynecology and Integrative Women’s Health, Peoria Workshop 6 “Bite-sized” Mindful Meditation: Strategies for Managing Stress, Work Relationships and Making

Decisions Nikki Lively, LCSW, University of Illinois Medical Center, Chicago

2:15 p.m. – 2:45 p.m. Health Information Break – Exhibit Room

2:45 p.m. – 3: 45 p.m. Concurrent Workshops – Session CWorkshop 7 Utilizing Social Media in the Workplace Curt Shannon, U.S. Centers for Disease Control and Prevention, Atlanta, GeorgiaWorkshop 8 Women, Bowel Diseases and Cancers Karen Kim, M.D., University of Chicago, ChicagoWorkshop 9 Generation Healthy Kemia Sarraf, M.D., M.P.H., GenH Coalition, Springfield

3:45 p.m. – 4:45 p.m. General Session I Crazy Sexy Life Kris Carr, Author, Filmmaker and Founder of crazysexylife.com, New York, New York

Kris Carr is a best-selling author, filmmaker and motivational speaker. She is the subject of the uplifting documentary, “Crazy Sexy Cancer.” The film, which she wrote and directed for TLC and the Discovery Channel, chronicles her adventure of living and thriving with stage-four cancer. At the podium, Carr takes audiences on her inspirational journey about living a full and healthy life while surviving cancer. Her witty anecdotes, diet advice, and tips for overcoming adversity motivate her audiences to think outside the box in order to become empowered participants in health and healing.

4:45 p.m. – 5 p.m. Author’s Table Book Signing Opportunity With Kris Carr

5 p.m. – 5:45 p.m. Zumba ® (optional)

6:30 p.m. – 7:30 p.m Reception – A Night at the Museum Abraham Lincoln Presidential Library and Museum 6:30 p.m. – 10 p.m. Tour of the Museum

We invite you to join us for an unforgettable evening at the Abraham Lincoln Presidential Museum, just a few short blocks away from the Hilton Springfield Hotel. Once there, you will be able to network and socialize with your colleagues while enjoying deli-cious hors d’ oeuvres on the Plaza. Then, you are welcome to explore The Journeys, which will take you through the inspiring life of President Lincoln and immerse you in the time expanding Lincoln’s early years through his presidency at our nation’s capital. Then, it will be on to the Treasures Gallery, where you will be in the presence of dozens of original artifacts owned or associated with the Lincolns. Also, to enhance your “Night at the Museum,” the Museum Store will be open for purchasing books and gift items. For more information about the museum, please visit the Abraham Lincoln Presidential Museum website at www.alplm.org.

All conference participants are invited to attend the reception and no one will be turned away. However, so we may provide a more accurate count to the museum, please check the box provided on the registration form. Thank you!

Thursday, November 3, 20117 a.m. – 7:45 a.m. Yoga (optional) 7:30 a.m. – 8:30 a.m. Breakfast Buffet

7:30 a.m. – 9 a.m. Registration

8 a.m. – 9 a.m. Breakfast Session - Integrating Humanism and Science in Medicine Theresa Gilewski, M.D., Memorial Sloan-Kettering Cancer Center, New York

Dr. Teresa Gilewski is a medical oncologist at the Breast Cancer Service, Department of Medicine, at Memorial Sloan-Kettering Cancer Center. Gilewski received a Bachelor of Science from Gannon University and a medical degree from Hahnemann University as part of a six-year combined B.S./M.D. program. She then completed training in internal medicine at Northwestern Memorial Hospital followed by a fellowship in hematology/oncology at the University of Chicago. Her current focus of research is the development of vaccines for patients with breast cancer at high risk of recurrence. Gilewski also created the Art of Medicine lecture series at Memorial Sloan-Kettering Cancer Center. This program focuses on the humanistic aspect of medicine. She directed, produced and wrote two films: “Reflections on Illness – an Interview with Dr. Alan Houghton” and “Living Through and Beyond Breast Cancer.” She also developed a film on “The Physician as the Patient,” which has been shown at the American Society of Clinical Oncology meetings.

9:15 a.m. – 10:15 a.m. General Session II – Chronic Disease Prevention and Adolescent Health Promotion Antronette K. Yancy, M.D., University of California at Los Angeles (UCLA)

Dr. Toni (Antronette K.) Yancey, is currently a professor in the Department of Health Services, UCLA School of Public Health, and is co-director of the UCLA Kaiser Permanente Center for Health Equity. Yancey’s primary research interests are in chronic disease prevention, with a focus on organizational practice and policy change, and adolescent health promotion. She returned to academia full-time in 2001 after five years in public health practice, first as director of public health for the city of Richmond, Va., and as director of chronic disease prevention and health promotion for the Los Angeles County Department of Public Health. Yancey has authored more than 125 scientific publications, including briefs, book chapters, health promotion videos, and among those, 90 peer-reviewed journal articles and editorials. She has generated $30 million in extramural funds, including four National Institutes of Health independent investi-gator (R01, R24) awards as principal investigator. She serves on the Institute of Medicine (IOM) Standing Committee on Childhood Obesity Prevention, and National Physical Activity Plan Coordinating Committee. From 2007-2009, during the CEO transition after retirement of the founder, she chaired the board of directors of the Oakland, Calif. based Public Health Institute.

10:15 a.m. – 10:30 a.m. Break and Hotel Check Out

10:30 a.m. – 11:30 a.m. Concurrent Workshop Session DWorkshop 10 The U.S. Food and Drug Administration: Programs They Monitor and What You Should Know Beverly Gallauresi, M.P.H., R.N., Office of Women’s Health, U.S. Food and Drug Administration, Washington, D.C. Lisa Misevicz, U. S., Food and Drug Administration, ChicagoWorkshop 11 Expand Your Life With a Lifespan of Exercise Suzanne Badillo, PT, WCS, Clinical Program Director, Women’s Health Rehabilitation Program, Rehabilitation Institute of ChicagoWorkshop 12 Birth Control Affects: Medicinal, Neurological, Cardiovascular and More Catherine Stika, M.D., Northwestern University, Chicago

11:40 a.m. – 12:40 p.m. Closing Luncheon Session – Women Have Balls Eliz Greene, Health Educator and Director, Embrace Your Heart Wellness Initiative, Milwaukee, Wisconsin

Eliz Greene was seven-months pregnant with twins when she suffered a massive heart attack. Her life changed – not only did she survive a 10-minute cardiac arrest, the cesarean delivery of her daughters and open-heart surgery, all on the same day – she gained new perspective and passion for life. Determined not to lose her new-found passion and to regain her health, Greene developed strategies to fit activity and healthy habits into her life. She lost the more than 80 pounds she gained while pregnant and has since become a recreational triathlete.

Her heart attack forced her to slow down and pay attention to what was important. To engage life rather than just endure it!

1 p.m. – 2:30 p.m. Illinois WISEWOMAN Meeting

1 p.m. – 2:30 p.m. Illinois Breast and Cervical Cancer Program Agency Meeting

2011 Conference Agenda 2011 Conference Agenda

Noon – 1:15 p.m. Luncheon and Healthy Cooking With Lindsey Lindsey Arenberg, M.S., LeCordon Bleu Baking and Pastry Chef, Chicago

1:15 p.m. – 2:15 p.m. Concurrent Workshops – Session BWorkshop 4 Obesity and Cancer Laura Rogers, M.D., Southern Illinois University School of Medicine, SpringfieldWorkshop 5 The Food – Health Connection Michelle Couri, M.D., Couri Center for Gynecology and Integrative Women’s Health, Peoria Workshop 6 “Bite-sized” Mindful Meditation: Strategies for Managing Stress, Work Relationships and Making

Decisions Nikki Lively, LCSW, University of Illinois Medical Center, Chicago

2:15 p.m. – 2:45 p.m. Health Information Break – Exhibit Room

2:45 p.m. – 3: 45 p.m. Concurrent Workshops – Session CWorkshop 7 Utilizing Social Media in the Workplace Curt Shannon, U.S. Centers for Disease Control and Prevention, Atlanta, GeorgiaWorkshop 8 Women, Bowel Diseases and Cancers Karen Kim, M.D., University of Chicago, ChicagoWorkshop 9 Generation Healthy Kemia Sarraf, M.D., M.P.H., GenH Coalition, Springfield

3:45 p.m. – 4:45 p.m. General Session I Crazy Sexy Life Kris Carr, Author, Filmmaker and Founder of crazysexylife.com, New York, New York

Kris Carr is a best-selling author, filmmaker and motivational speaker. She is the subject of the uplifting documentary, “Crazy Sexy Cancer.” The film, which she wrote and directed for TLC and the Discovery Channel, chronicles her adventure of living and thriving with stage-four cancer. At the podium, Carr takes audiences on her inspirational journey about living a full and healthy life while surviving cancer. Her witty anecdotes, diet advice, and tips for overcoming adversity motivate her audiences to think outside the box in order to become empowered participants in health and healing.

4:45 p.m. – 5 p.m. Author’s Table Book Signing Opportunity With Kris Carr

5 p.m. – 5:45 p.m. Zumba ® (optional)

6:30 p.m. – 7:30 p.m Reception – A Night at the Museum Abraham Lincoln Presidential Library and Museum 6:30 p.m. – 10 p.m. Tour of the Museum

We invite you to join us for an unforgettable evening at the Abraham Lincoln Presidential Museum, just a few short blocks away from the Hilton Springfield Hotel. Once there, you will be able to network and socialize with your colleagues while enjoying deli-cious hors d’ oeuvres on the Plaza. Then, you are welcome to explore The Journeys, which will take you through the inspiring life of President Lincoln and immerse you in the time expanding Lincoln’s early years through his presidency at our nation’s capital. Then, it will be on to the Treasures Gallery, where you will be in the presence of dozens of original artifacts owned or associated with the Lincolns. Also, to enhance your “Night at the Museum,” the Museum Store will be open for purchasing books and gift items. For more information about the museum, please visit the Abraham Lincoln Presidential Museum website at www.alplm.org.

All conference participants are invited to attend the reception and no one will be turned away. However, so we may provide a more accurate count to the museum, please check the box provided on the registration form. Thank you!

Thursday, November 3, 20117 a.m. – 7:45 a.m. Yoga (optional) 7:30 a.m. – 8:30 a.m. Breakfast Buffet

7:30 a.m. – 9 a.m. Registration

8 a.m. – 9 a.m. Breakfast Session - Integrating Humanism and Science in Medicine Theresa Gilewski, M.D., Memorial Sloan-Kettering Cancer Center, New York

Dr. Teresa Gilewski is a medical oncologist at the Breast Cancer Service, Department of Medicine, at Memorial Sloan-Kettering Cancer Center. Gilewski received a Bachelor of Science from Gannon University and a medical degree from Hahnemann University as part of a six-year combined B.S./M.D. program. She then completed training in internal medicine at Northwestern Memorial Hospital followed by a fellowship in hematology/oncology at the University of Chicago. Her current focus of research is the development of vaccines for patients with breast cancer at high risk of recurrence. Gilewski also created the Art of Medicine lecture series at Memorial Sloan-Kettering Cancer Center. This program focuses on the humanistic aspect of medicine. She directed, produced and wrote two films: “Reflections on Illness – an Interview with Dr. Alan Houghton” and “Living Through and Beyond Breast Cancer.” She also developed a film on “The Physician as the Patient,” which has been shown at the American Society of Clinical Oncology meetings.

9:15 a.m. – 10:15 a.m. General Session II – Chronic Disease Prevention and Adolescent Health Promotion Antronette K. Yancy, M.D., University of California at Los Angeles (UCLA)

Dr. Toni (Antronette K.) Yancey, is currently a professor in the Department of Health Services, UCLA School of Public Health, and is co-director of the UCLA Kaiser Permanente Center for Health Equity. Yancey’s primary research interests are in chronic disease prevention, with a focus on organizational practice and policy change, and adolescent health promotion. She returned to academia full-time in 2001 after five years in public health practice, first as director of public health for the city of Richmond, Va., and as director of chronic disease prevention and health promotion for the Los Angeles County Department of Public Health. Yancey has authored more than 125 scientific publications, including briefs, book chapters, health promotion videos, and among those, 90 peer-reviewed journal articles and editorials. She has generated $30 million in extramural funds, including four National Institutes of Health independent investi-gator (R01, R24) awards as principal investigator. She serves on the Institute of Medicine (IOM) Standing Committee on Childhood Obesity Prevention, and National Physical Activity Plan Coordinating Committee. From 2007-2009, during the CEO transition after retirement of the founder, she chaired the board of directors of the Oakland, Calif. based Public Health Institute.

10:15 a.m. – 10:30 a.m. Break and Hotel Check Out

10:30 a.m. – 11:30 a.m. Concurrent Workshop Session DWorkshop 10 The U.S. Food and Drug Administration: Programs They Monitor and What You Should Know Beverly Gallauresi, M.P.H., R.N., Office of Women’s Health, U.S. Food and Drug Administration, Washington, D.C. Lisa Misevicz, U. S., Food and Drug Administration, ChicagoWorkshop 11 Expand Your Life With a Lifespan of Exercise Suzanne Badillo, PT, WCS, Clinical Program Director, Women’s Health Rehabilitation Program, Rehabilitation Institute of ChicagoWorkshop 12 Birth Control Effects: The Challenges Facing Women With Medical Problems Catherine Stika, M.D., Northwestern University, Chicago

11:40 a.m. – 12:40 p.m. Closing Luncheon Session – Women Have Balls Eliz Greene, Health Educator and Director, Embrace Your Heart Wellness Initiative, Milwaukee, Wisconsin

Eliz Greene was seven-months pregnant with twins when she suffered a massive heart attack. Her life changed – not only did she survive a 10-minute cardiac arrest, the cesarean delivery of her daughters and open-heart surgery, all on the same day – she gained new perspective and passion for life. Determined not to lose her new-found passion and to regain her health, Greene developed strategies to fit activity and healthy habits into her life. She lost the more than 80 pounds she gained while pregnant and has since become a recreational triathlete.

Her heart attack forced her to slow down and pay attention to what was important. To engage life rather than just endure it!

1 p.m. – 2:30 p.m. Illinois WISEWOMAN Meeting

1 p.m. – 2:30 p.m. Illinois Breast and Cervical Cancer Program Agency Meeting

Exhibitor InformationConference attendees will have ample opportunity to visit the exhibit hall throughout the day on Wednesday, November 2. In addition, extended morning and afternoon breaks have been included in the schedule to give exhibitors maximum exposure to conference attendees. Exhibit space is limited, so register early. Space will be assigned on a first-come, first-served basis.

Exhibitor Benefits• Ability to network with health professionals throughout the

Midwest• Recognition in conference program• One complimentary conference registration included in

exhibitor fee• Two additional registrations available for exhibiting organi-

zation at a reduced rate of $75 each• Conference signage• Recognition in Office of Women’s Health newsletters,

website and news releases

Exhibit Fee – For-profit Organizations One, 6-foot skirted table with two chairs ..................$150 Note: $25 discount if contract and payment is received by October 1, 2011.

Exhibit Fee – Not-for-profit Organizations One, 6-foot skirted table with two chairs ..................$125 Note: $25 discount if contract and payment is received by October 1, 2011.

Table AssignmentSpace is assigned based on receipt of contract and payment. All contracts received with payment will be confirmed with table number on a space available basis. The Office of Women’s Health reserves the right to make assignments or reassign-ments as necessary.

RegistrationExhibitors will be required to register and wear name badges.

Exhibit ScheduleExhibit Set-Up Wed., Nov. 2 7:30 a.m. – 8:30 a.m.Exhibits Open Wed., Nov. 2 8:30 a.m. – 3 p.m.Dismantling Wed., Nov. 2 3 p.m.

Exhibit Shipping, Electricity and Other ItemsAny additional equipment will be contracted and paid for directly through the Hilton Springfield Hotel. Contact information and forms will be provided with your conference exhibitor kit, which will be mailed to you on October 15, 2011. Shipping and storage information also will be outlined in the exhibitor kit. If electricity is required for your exhibit, please check the appropriate box on the contract and include the extra charge with your payment.

Hilton Springfield Hotel Reservation Line: 217-789-1530 or 800-HILTONS • Online: www.springfieldil.hilton.comTo receive the conference rate, state your reservation is for the Illinois Women’s Conference room block.

Sponsorship InformationAdditional opportunities are available to showcase your service or organization through sponsorships. Contact Brenda Blasko at 217-524-1844 or Emily Doering at 312-814-7098 if you would like to sponsor an event or item not listed below.

Sponsorship Benefits• One free exhibit table• Complimentary conference registration (based on spon-

sorship amount (Gold–4, Silver–3 and Bronze–2)• Conference signage• Recognition in the conference program• Pre- and post-conference recognition• One set of pre-registered attendee mailing labels upon

request• Recognition in OWH newsletters, website and news releases

Sponsorships AvailableGold ..................................................................$5,000 and upSilver..............................................................$3,000 – $4,999Bronze ...........................................................$1,000 – $2,999

Additional SponsorshipsContinental Breakfasts .................................................$1,750Lunch or Reception ......................................................$3,500Keynote and General Session ......................................$3,000Health Information Break ..............................................$1,500Education Sessions ................................... Call 217-524-1844

(Additional sponsorship benefits include recognition on the event sign and the opportunity to introduce the speaker at sessions/workshops.)

2011Illinois Women’s

Health ConferenceGain access to the knowledge, resources and expertise of

national speakers, universities, medical facilities, statewideand community-based organizations, and local affiliates.

For more information on registration, exhibit orsponsorship opportunities, visit www.ipha.com or

www.idph.state.il.us/about/womenshealth/owh.htm.Refer to insert for registration form.

November 2-3, 2011Hilton Springfield Hotel • Springfield, Illinois

Illinois Public Health Association223 S. Third St.Springfield, IL 62701-1144

Non-Profit Org.U.S. Postage

PAIDSpringfield, ILPermit No. 577

Register Today!

November 2-3, 2011Hilton Springfield Hotel700 E. Adams St.Springfield, IL 62701

Register to exhibit byOctober 1 and save!

Online registraton also will beavailable beginning August 22at www.ipha.com.

Printed by Authority of the State of Illinois

Thank you to our 2011 Sponsors and Contributors!

SponsorsAmerican Cancer Society

American Heart AssociationColor World

Illinois Department of Public HealthIllinois Public Health Association

Susan G. Komen for the Cure – Peoria Memorial

ContributorsIllinois Nurses Association

Chambers and Associates LLCU.S. Department of Health and Human Services –

Office on Women’s HealthU.S. Department of Health and Human Services –

HIV/AIDS Regional Resource Network Program – Region VOakton Community College

Institute for Women’s Health Research at Northwestern University

Jewel-Osco/Super Value – Midwest RegionSouthern Illinois University School of Medicine

St. John’s College of NursingUniversity of Illinois at Chicago – Center of Excellence

Contract for Exhibit Space, Sponsorship and Advertising2011 Illinois Women’s Health Conference

Please print all information clearly. Each attending exhibitor MUST complete a registration form as well as the information listed below. The Illinois Public Health Association and the

Office of Women’s Health (OWH) are not responsible for errors made due to illegible writing.

____________________________________________________Company Name (As it should be presented in all materials)

____________________________________________________Contact Person (Every exhibitor must identify a main contact.

The main contact will receive all conference information.)

____________________________________________________Signature of Contact Person

Mailing Address _______________________________________

City ________________________________________________

State ________________ZIP Code _______________________

Phone _____________________ Fax _____________________

E-mail ______________________________________________

Exhibitor attending conference, if different from main contact

Name _______________________________________________

Company ____________________________________________

Address _____________________________________________

City ________________________________________________

State ________________ZIP Code _______________________

Phone _____________________ Fax _____________________

E-mail ______________________________________________

Additional exhibitor registrant (See registration form for fees. Requires additional registration payment and registration form.)

Name _______________________________________________

Company ____________________________________________

Address _____________________________________________

City ________________________________________________

State ________________ZIP Code _______________________

Phone _____________________ Fax _____________________

E-mail ______________________________________________

Brief description of your organization to be included in 2011 program booklet:

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

Check the appropriate boxes below:Exhibit Space – For-profit One, 6-foot skirted table with chairs ................................$150 Note: Early bird discount of $25 if contract and payment (or proof of payment) is received by October 7, 2011.

Exhibit Space – Not-for-profit One, 6-foot skirted table with chairs ................................$125 Note: Early bird discount of $25 if contract and payment (or proof of payment) is received by October 7, 2011.

Sponsorships

Gold ..................................................................$5,000 and up

Silver ...............................................................$3,000 – 4,999

Bronze ...........................................................$1,000 – $2,999

Additional Sponsorships

Continental Breakfasts .................................................$1,750

Lunch or Reception ......................................................$3,500

Keynote and General Session......................................$3,000

Refreshments Break.....................................................$1,500

Payment InformationExhibit Fee (For-profit organization) $ ________________

Exhibit Fee (Not-for-profit organization) $ ________________

Additional Exhibitor Registrant $ ________________

Electrical Hook-up ($50) $ ________________

Sponsorship $ ________________

Enclosed is a check for $ ________________

Online registration and payment is available by visiting theIllinois Public Health Association (IPHA) website (www.ipha.com). Conference exhibitors and sponsors who register online may choose to make their payment with Visa or MasterCard. For additional information, call IPHA at 217-522-5687, or visit the website.

IPHA Tax ID # 36-6108790

Questions? Please call:Angie Wanger at 217-522-5687 (IPHA), or

Brenda Blasko at 217-524-1844 (OWH)

The information contained in this prospectus is hereby made part of this contract. Payment or proof of payment

must accompany contract form in order for the registration process to be completed. Please retain a copy of this

contract for your records and return original to:

Illinois Public Health Association223 S. Third St. • Springfield, IL 62701-1144

Fax: 217-522-5689

Conference Registration Form • 2011 Illinois Women’s Health ConferencePlease note the following instructions for completing your registration form:

1. TYPE or PRINT CLEARLY the following information (as it should appear on your name badge). This form must be completed in its entirety in order for your registration to be processed. One completed registration form is required for each additional person from your organization attending the conference.

2. This registration form and payment or voucher must be received by October 7, 2011, to ensure the early registration rate of $115. The rate of $125 will be in effect from October 7, 2011 – November 3, 2011. On-site registrations will be charged the $125 rate with payment due at the time of registration.

3. Cancellation of registration must be received in writing by November 1, 2011. Cancellations must be faxed to IPHA at 217-522-5689. No refunds will be made for cancellations received after November 1, 2011. However, a registration may be transferred to another attendee from the same organization. Registrants who do not submit a written cancellation to IPHA by the stated date and do not attend the conference will still be responsible for payment of the registration fee.

First Name __________________________________ M.I. __________ Last Name ________________________________________

Organization ________________________________________________________________________________________________

Organization Mailing Address ___________________________________________________________________________________

City ________________________________________________________ State _________________ ZIP Code _________________

Business Telephone _________________________________ Business Fax _____________________________________________

Business E-mail ______________________________________________________________________________________________

There will be a “program participant list” available that includes the names and addresses of each conference registrant. Please check the appropriate box with regard to use of your name. IF NEITHER BOX IS CHECKED, YOUR NAME WILL BE INCLUDED WITH THE ADDRESS USED ON THIS REGISTRATION FORM. You may include my name and BUSINESS ADDRESS as it appears on this registration form in the program participant list. I do not wish to have my name and address included in the program participant list.

REGISTRATION FEES AND ADDITIONAL INFORMATION (please check appropriate box)

$115 – Early registration $125 – Late registration and/or On-site registration (after October 7, 2011)

$75 – One-day (1st day) registration $75 – Student registration (for both days)

$50 – One-day (2nd day) registration (NOTE: To quality for the student rate, you must be a current, full-time student in an undergraduate or graduate program and present appropriate identification.)

Check ALL dates you plan to attend: Pre-conference Selection (please choose one workshop to attend): I will attend Wednesday, November 2 Workshop I – Eat Smart – Live Strong I will attend the “Night at the Museum” Reception Workshop II – Fresh From the Farm I will attend Thursday, November 3 Workshop III – Illinois Helps Workshop IV – Institute of Medicine Update

Special needs (diet, access, other)_____________________________________________________________________

TOTAL PAYMENT ENCLOSED: $ _____________(Make checks payable to Illinois Public Health Association)

IPHA Tax ID # 36-6108790

Online registration and payment is available by visiting the Illinois Public Health Association (IPHA) website (www.ipha.com). Conference participants who register online may choose to make their payment with

Visa or Mastercard. For additional information, call IPHA at 217-522-5687, or visit the website.

Completed registration form with payment should be mailed to:Illinois Public Health Association • 223 S. Third St. • Springfield, IL 62701-1144

Three ways to register:1. Register by mail

2. Register by faxing registration to 217-522-56893. Register online at www.ipha.com

Hilton Springfield Hotel Reservation Line: 217-789-1530 or 800-HILTONS • Online: www.springfieldil.hilton.comTo receive the conference rate, state your reservation is for the Illinois Women’s Conference room block.

Welcome [app.idph.state.il.us]app.idph.state.il.us/docs/FINAL2011OWH_Registration.pdf · The four...

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