Fillable PRELIMINARY BUDGET FORM (Northside Hospital)

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PRELIMINARY BUDGET FORM (Northside Hospital)

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Addendum to CME Application
PRELIMINARY BUDGET FORM
Activity Title: ____________________________________________
Activity Date: ____________________________________________
Estimated Funding / Revenue
Registration Fees
$
Exhibit Fees
$
Vendor company name:
$
Vendor company name:
$
Vendor company name:
$
Vendor company name:
$
Educational Grant Funding
$
Commercial company name:
$
Commercial company name:
$
Commercial company name:
$
Commercial company name:
$
CME Approval Fees
$
Other:
$
Other:
$
Total Estimated Revenue
$
Estimated Expenses
Budget Item
Estimated Expense
Description
Audio/Visual
$
A/V equipment & staff
Meeting Room
$
Room rental
Catering
$
Food and beverage
Honoraria
$
Speaker Travel
$
Speaker Lodging
$
Speaker Ground Transportation
$
Marketing & Distribution
$
Consultant Fees
$
Planning Committee Expenses
$
Hotel, Parking, Mileage
Other
$
Total Estimated Expenses
$
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PRELIMINARY BUDGET FORM (Northside Hospital)

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Completed 6 June 2021

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