Annual Meeting Supplement Ad Submission Form


Institutional Information

Advertiser Department:
*Contact Name:
*Contact E-mail:
Contact e-mail is required for AHA use only, in case we have questions about the ad. It will not be listed in the ad itself. Upon receipt of this form, a confirmation message will be sent to this address.
*Contact Phone:

Next Available Annual Meeting Program Supplement

2016 (Next Available Program Supplement)


File Upload

Please click the 'Browse' button to select and upload your ad file. If you have additional files, you may upload them by following the directions on the following screen, or in the confirmation email that you receive after submitting this form. You may add up to three files total. Please note, depending on the speed of your internet connection, submitting large files may take a long time. For best results, we recommend that you put your files into a zip or stuffit archive.

If your file is not yet ready, you may submit this form to reserve space and upload your ad at a later time.

Please ensure that the file name contains the following elements: A short form of the advertiser's name; some part of the ad content or its heading and the date of submission in the form of mmddyy.

File 1

Notes about this file:



*Number of Ads. If you are submitting an ad spread, please count each page in your spread separately and select the total number in the drop down list

*Ad Size:


Miscellaneous Information

Request Typesetting (check if you are NOT uploading camera ready copy). Additional fees apply.

*I have read and agree to abide by the advertising policy.

*Is this a job ad? (for statistical purposes only)

Special Requests, page location, or other information:

Note: After submitting this form, you should receive a confirmation email to confirm receipt. Please note, however, that receipt does not guarantee publication, or placement requests. AHA staff will be in contact with you to coordinate and confirm the details.

Enter billing information

Bill to:

*Billing Name:   Check here if this is an agency (15% discount).
*Billing Company:
Billing Address 1:
Billing Address 2:
*City:    *State:     *ZIP:
Purchase Order Number: (Optional)

Form Verification

Please Note: Depending on the speed of your internet connection, and the size of the file that you are submitting, it may take several minutes for this form to submit. Please be patient and do not click the submit button repeatedly, or close your browser until you see the confirmation page.