Clone of 2025 APT Conference - Exhibitor/Sponsor Registration

2026 Annual Perinatal Conference

Sponsor and Exhibitor Registration Form
Business/Company Name
Type of Business
Contact Person

First NameLast Name
Contact Person E-mail
Contact Person Phone Number

Area CodePhone Number
Affiliation
i.e. - Health System, Small Non-Profit, School, Medical Equipment, Medical Supplies
Address

Street Address

Street Address Line 2

CityState

Zip Code
Attendee

First NameLast Name
Attendee Credentials
Attendee RN License #
Attendee E-mail
How would you like your name printed on your badge?
2nd Attendee (Sponsors Only)

First NameLast Name
2nd Attendee Credentials
2nd Attendee RN License #
2nd Attendee E-mail
How would you like your name to be printed on your badge
Exhibit Details

If you have specific needs that are not covered in the Exhibitor Prospectus, please contact apt@azperinatal.org. Additional fees may apply.
Please indicate how you will submit your organization's logo:
Please upload a Hi-Res copy of your logo here.

Browse Files
*.png is preferred, but a .jpeg is acceptable. Cancelof
Will you be providing an item/basket to raffle off at the end of the conference?
*This question pertains to the raffle we provide tickets for at the closing of the conference, not if you are holding your own raffle.
Do you need an electrical outlet? (A communal mobile phone charging station will be provided.)
Payment Type
Exhibitor/Sponsor Type - Check Payment
An electrical outlet can be provided to your booth if needed. Please indicate that you require one by adding the $50 Electrical Outlet fee in the pricing options below.

(A free communal phone charging station will be provided by the venue.)
Registration Fees
When you click "Submit Registration", you will receive an email with mailing instructions for your check. If you have selected to add an electrical outlet for your equipment at your booth, please include the additional $50 in your total check amount.
Registration Fees
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Sponsor (2 Attendees)$2,587.50
Vendor fee + processing fee

Exhibitor (1 Attendee) - (e.g. individual hospitals, medical equipment companies, universities)$1,035.00
Vendor fee + processing fee

Non-Profit Community Partner (1 Attendee) - (e.g. IHS, health departments, small non-profits, small community organizations)$517.50
Vendor fee + processing fee

Electrical Outlet (optional addition for an outlet at your table)$51.75
Electrical outlet fee + processing fee

Total $0.00
When you click "Submit Registration", you will be redirected to the PayPal login.
IF YOU HAVE a PayPal account, login and complete your payment.

IF YOU DO NOT HAVE a PayPal account, select the button, on the bottom of the PayPal login form, labeled "Pay with Credit or Debit Card."

IF YOU WANT TO PAY BY CHECK, scroll up and select the Payment Method "Check."
Refunds will not be issued for Exhibitors who fail to occupy their space. Should you have any questions about your registration you can email apt@azperinatal.org.
Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info
Should be Empty:

2026 Annual Perinatal Conference

Exhibit Details

Registration Fees*

Payment Methods

Registration Fees