Missouri Society of Radiologic Technologists

Company you represent:*

Company Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Fax Number:

Website/webpage:*

This will be linked to, on our Annual Conference 2025 - Corporate Sponsor ARCHIVE page when it is ready (usually no more than 30 days after Conference has ended).

Corporate Contact Person or Other Contact

Full Name:*

PrefixFirst NameMILast NameSuffix

Title:

Your Primary Email Address:*

Confirmation Email

Your Alternate Email Address:

Confirmation Email

Telephone/Contact Number:*

Work Number:

Name(s) of the Person(s) Attending:

$150 - Single Page Flyer - Welcome Packet

Please acknowledge the following:

It is the responsibility of the Sponsor to make sure the fliers are sent to the MoSRT Conference Chair prior to the start of the 2025 Annual Conference by March 28, 2025. Any delay in this could potentially cause the fliers to not be included in the Welcome Packets.Fliers must be sent to the following address: William Oller 207 Lexington Ct. Crystal City, MO 63019.For the 2018 Annual Conference, we had around 275 registrants. A more specific number can be made available this year as we get closer to the close of pre-registration if you would like. In an effort to prevent overwhelming the Conference Registration chair, please email Carolyn Mues for this information.

Event Booth ($250-$350)

1.) Draped, 8ft table in the registration area.
2.) Meals for two (2) individuals for day(s) registered.
3.) Slideshow display during event.
4.) Logo/text recognition on MoSRT website.
5.) Emcee acknowledgment.

$250 - One (1) Day$300 - Two (2) Days$350 - Full Conference$25 - Electrical outlet

Sponsor a Speaker - ($350)

1.) Two-minute overview of your company.
2.) Introduce the speaker.
3.) Logo on the program.
4.) Provide a 1-page flyer given to all registrants upon check-in.
5.) Logo/text recognition on MoSRT website and conference communication.

$350 - Please email me the list of speakers available to sponsor.$350 - The Corporate Sponsorship committee can pick our speaker to sponsor.

Social Night Sponsor - Wednesday ($500)

1.) Acknowledgment of your support by emcee or participate in event with the emcee!
2.) Slideshow display during event
3.) Logo/text recognition on MoSRT website and conference communications.
4.) Logo on social night flyer and on program.

Full Sponsorship - $1,000Partial Sponsorship - $500

Sponsor a Refreshment Break - Thursday

1.) Acknowledgment of your support by event emcee.
2.) 30-second video or slide displayed during session breaks.
3.) Logo/text recognition on MoSRT website and conference communications.
4.) Flyers placed at refreshment table.
5.) Logo on program.

$400 Full Sponsorship - Morning Break - Thursday April 03, 2025$200 Partial Sponsorship - Morning Break - Thursday April 03, 2025$400 Full Sponsorship - Afternoon Break - Thursday April 03, 2025$200 Partial Sponsorship - Afternoon Break - Thursday April 03, 2025

Sponsor a Refreshment Break - Friday

1.) Acknowledgment of your support by event emcee.
2.) 30-second video or slide displayed during session breaks.
3.) Logo/text recognition on MoSRT website and conference communications.
4.) Flyers placed at refreshment table.
5.) Logo on program.

$400 Full Sponsorship - Morning Break - Friday April 04, 2025$200 Partial Sponsorship - Morning Break - Friday April 04, 2025$400 Full Sponsorship - Afternoon Break - Friday April 04, 2025$200 Partial Sponsorship - Afternoon Break - Friday April 04, 2025

Sponsor a Meal

1.) Acknowledgment of your support by event emcee.
2.) 30-second video or slide displayed during session breaks.
3.) Logo/text recognition on MoSRT website and conference communications.
4.) Flyers placed at refreshment table.
5.) Logo on program.
6.) Speak to attendees up to five (5) minutes during meal

$1500 - First Business Session - Breakfast - Thursday April 03, 2025$1500 - Afternoon Lunch - Thursday April 03, 2025$1500 - Second Business Session - Breakfast - Friday April 04, 2025$1500 - Third Business Session - Lunch - Friday April 04, 2025$1500 - Presidential Banquet - Dinner - Friday April 04, 2025

Competition Awards - $600

1.) Sponsor student/technologist essay, exhibit, and scholarship competitions
2.) 30-second video or slide displayed during session breaks.
3.) Logo/text recognition on MoSRT website and conference communications>
4.) Acknowledgment of your support by emcee.

$600 - Technologist Essay$600 - Student Essay$600 - Technologist Exhibit$600 - Student Exhibit$600 - Coretta Schroer Memorial Technologist Scholarship$600 - Mary J. Feldhaus Memorial Technologist Scholarship$600 - Henry Y. Cashion Memorial Student Scholarship$600 - Robert A. Feldhaus Memorial Student Scholarship$600 - Stephanie A.Whisler Memorial Student Scholarship

Other Donation:

How would you like your "Other Donation" distributed:

Silent Auction Donations:

Proceeds benefit the Student and Technologist scholarship funds.

Door Prize Item(s):

Total:

Payment Method:*

I will pay using the payment wizard below.I will send in my payment to the MoSRT Executive Treasurer

If you will be submitting a check/money order please send it to the following address:

Janet Akers-Montgomery
5840 Busiek Road

Farmington MO 63640

Please make checks payable to: MoSRT

Corporate Sponsorship Total:

USDDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

- Corporate Sponsorship Application-