2022 Exhibiting Display Registration Form

Exhibiting Display Registration Form

2022 National Latinx Conference on HIV/HCV/SUD (March 24-26, 2022)
Please enter your contact information
Name *
Title *
Company *
Email *
Phone Number

Area Code Phone Number
Please enter your company information EXACTLY as you would like it to appear in promotional material:
Company Name *
Website
Phone Number

Area Code Phone Number
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Below are options in which you can participate in the conference. Select all that apply.
Exhibiting Opportunities

$2,000: Digital Loteria/Bingo, Logo on Website, Social Media Posts, Conference Bag Item, Reference in Digital Program, Virtual Exhibit via Whova, Email Rolodex of all Exhibitors/Sponsors
Sponsorship Opportunities - Please select one

Bronce (Bronze) $15,000: Please see the conference prospectus Plata (Silver) $25,000: Please see the conference prospectus Oro (Gold) $50,000: Please see the conference prospectus Diamante (Diamond) $60,000: Please see the conference prospectus

A-la-Carte Options: Please fill in the table below with the individualized items you'd like to purchase from the prospectus with the accompanying information.

	Price	Item
1
2
3
4

Once your registration is complete you will recieve a confirmation email.

Please do not forget to download, complete, and return the payment authorization form found on our website (https://latinosandhiv.org/exhibitors-sponsors/). When completed, send to Marco Martinez (MarcoMartinez@valleyaids.org).

Thank you and we are excited to have you be part of the 2022 National Latinx Conference on HIV, HCV, & SUD!
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