Distribute the Medicine Grassroots Conference Registration & Sponsorship Form
Register for the conference, select meal options, and explore sponsorship opportunities.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Lunch Preference - Day 1 (June 5)
*
Chicken Salad Wrap
Turkey Wrap
Veggie Wrap (vegan/gluten free)
Lunch Preference - Day 2 (June 6)
*
Chicken salad croissant box
Meatball sub box
Veggie hummus box (Vegan_Gluten Free
Lunch Preference - Day 3 (June 7)
*
Salad box
Dinner Preference - Day 1 (June 5)
*
Alfredo Vegetable Lasagna Vegan/Gluten free
Traditional lasagna
Dinner Preference - Day 2 (June 6)
*
Vegan butternut squash ravioli
Bourbon chicken
Salad and baked potato bar
Dinner Preference - Day 4 (June 8)
*
Bruschetta stuffed chicken
Boneless fried chicken
Salad and baked potato bar
Sponsorship Level
Please Select
TABLE OF 10 ($5,400.00) Sponsor 10 people (students, educators, or volunteers). Reserved seating. Program recognition
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ONE FULL ATTENDEE ($540.00) Cover one person’s entire conference cost (all 3 days, 2 meals/day). Can be a student, educator, or volunteer.
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LUNCH SPONSORSHIP (you choose $) Sponsor one lunch for all 100+ people. Name on food table.
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BEVERAGE / COFFEE (you choose $)
Keep everyone hydrated. Signage at the drink station.
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TRAVEL & ACCOMMODATION (you choose) Fund gas, bus ticket, or hotel for someone who cannot afford to get here.
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MATCHING SPONSOR example [up to $1,000 match] Double every small donation we raise.
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EVERYTHING IS FOR SALE Name your amount. Any part of the conference can be sponsored. Just ask.
Fiscal Sponsor Donated to:
Please Select
Selenite & Sage Healing Homestead Co. > 501(c)(3) Nonprofit Organization EIN: 33-4417542 > 2427 BAXTER RD SW ATLANTA GA 30315-7201 https://seleniteandsage.com/
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Ohio Families Unite Against Police Brutality > 501(c)(3) Nonprofit Organization EIN: 85-1278755 >245 BLUECREST AVE DAYTON OH 45417-8910 https://OFUAPOLICEBRUTALITY.COM
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Or you can send directly to EAGER www.joineager.com/grassrootsconference
If you selected a sponsorship level, please specify any sponsor-specific items or preferences (e.g. lanyards, tote bags, coffee breaks, app, water bottles, scholarships)
Please let us know your accessibility needs
Register
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