MCH Sponsor Form with Payment

Sponsorship Registration

Fill out the form below to indicate your desired sponsorship level.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Please provide a high-resolution logo (300 dpi) for inclusion on conference materials.

Cancelof

Sponsorship Levels

Diamond Level: $3,000+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$3,000.00

Platinum Level: $1,000+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$1,000.00

Gold Level: $500+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$500.00

Silver Level: $350+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$350.00

Bronze Level: $200+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$200.00

Exhibitor Level: $175+

If you desire to donate more than this sum, kindly also select the "Additional Contribution" option below and specify your preferred amount.

$175.00

Advertising Opportunity

$100.00 Quantity

Additional Contribution

$25.00 Contribution Amount

Total

$0.00

Sponsorship Registration