WAPA 2026 APP Leadership Summit: Partnership Request Form

WAPA 2026 APP Leadership Summit Partnership Request Form

Submit your organization’s partnership or sponsorship interest for the Wisconsin Academy of PAs 2026 APP Leadership Summit. Please complete all required sections; WAPA will confirm availability and follow up with payment instructions.
Partner with the Wisconsin Academy of PAs for the 2026 APP Leadership Summit and connect with approximately 100–125 PAs, NPs, advanced practice professionals, clinical leaders, practice owners, educators, entrepreneurs, students, and healthcare decision-makers from across Wisconsin.

This focused, one-day leadership experience is built around actionable education, meaningful interaction, innovation, entrepreneurship, and improved access to care. Partner exhibits will be located within the summit’s primary networking flow, providing repeated opportunities for meaningful attendee engagement throughout the day.

Partnership opportunities are limited and will be confirmed in the order completed commitments and required payments are received.
Early pricing is available through October 1, 2026. All opportunities are subject to availability and WAPA confirmation.
Organization or company name
Organization type
Organization website
Street address
Address line 2
City
State
ZIP code
Primary contact’s full name

First NameLast Name
Primary contact’s professional title
Primary contact’s email address
example@example.com
Primary contact’s telephone number
Please enter a valid phone number.Format: (000) 000-0000.
Organization LinkedIn or social-media page
Primary Partnership Opportunities
Please describe the partnership opportunity or customized arrangement you would like WAPA to consider.
Would you like to sponsor the WAPA SWAG-BAG Challenge? This is a passport incentive activity encouraging registered attendees to visit and interact with EVERY exhibitor for a chance to WIN THE PRIZE. --$189
Individual Sponsorship Opportunities
*The Premier Leadership Partnership is limited to one organization. **Leadership Partnerships are limited to three organizations. ***Sponsored Lunch is available as a stand-alone opportunity only if the Premier Leadership Partnership remains unreserved as of October 1, 2026.
Is the billing contact the same as the primary contact?
Billing contact’s full name

First NameLast Name
Billing contact’s professional title
Billing contact’s email address
example@example.com
Billing contact’s telephone number
Please enter a valid phone number.Format: (000) 000-0000.
Is the billing address the same as the organization address?
Billing street address
Billing address line 2
Billing city
Billing state
Billing ZIP code
Accounts-payable email address
example@example.com
Preferred payment method
Purchase-order number
Does your organization require WAPA to complete a vendor-registration process?
Vendor-registration instructions or website
Vendor-registration contact name

First NameLast Name
Vendor-registration contact email
example@example.com
Special invoicing instructions
Do not enter credit-card, bank-account, or other sensitive financial information in this form. WAPA will provide appropriate payment instructions after confirming the partnership.
Organization name exactly as it should appear in summit materials
Organization description (maximum 100 words)
Organization logo upload

Cancelof
Approved website address for a potential QR-code link
Preferred social-media handle
Primary marketing or communications contact
Marketing contact email
example@example.com
Does your request involve an exhibit table?
Anticipated number of representatives
Representative names and email addresses
Electrical access needed?
Wi-Fi access needed?
Will the exhibit include equipment, a large display, or materials extending beyond a standard six-foot table?
If Yes or Unsure, please describe the equipment, display, or additional space requested.
Accessibility accommodations or special exhibit requirements
Dietary restrictions for participating representatives
Additional questions or fulfillment requests
Representative names and final exhibit details may be provided or updated after WAPA confirms the partnership.
REQUEST STATUS
I have reviewed and agree to the payment and reservation terms described above.
I understand and agree to WAPA’s partnership principles and educational-independence requirements.
I am authorized to submit this partnership reservation request on behalf of the organization identified in this form.
I understand that submitting this form does not guarantee availability or automatically reserve the selected opportunity.
I understand that WAPA must confirm the selected opportunity and will provide an invoice or payment instructions.
I understand that a limited or exclusive opportunity is not reserved until WAPA receives the required agreement and payment.
I certify that the information provided in this form is accurate to the best of my knowledge.
Authorized representative’s full name

First NameLast Name
Authorized representative’s professional title
Date Requested

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Selected items and associated cost
This form is administered by the Wisconsin Academy of PAs for the 2026 APP Leadership Summit. Information submitted through this form will be used to administer partnership, sponsorship, exhibitor participation, billing, and event fulfillment. It will not be used for unrelated marketing purposes.
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WAPA 2026 APP Leadership Summit Partnership Request Form