Sponsor a Long-term Care Event | AZ

Full Company Name:*

Contact Name:*

First Last

Title:

Address:*

Street Address City State ZIP Code

Email:*

Work Phone:*

Cell Phone:

Sponsor Event:*

AHCA Quality Forums
AHCA Seminar/Workshop

Quality Forums Sponsorship:

Platinum Sponsor - $10,000+
Includes: Four attendees from the sponsoring company, Logo on all Forum materials, Logo on AHCA website event calendar page, Includes all scheduled Forums for the year, Brief presentation during the Forum, Company signage at Forum, sponsor rep tables, Two attendees from the sponsoring company, Branding on Forum promotional materials.

Gold Sponsor All Sessions - $5,000 to $9,999
Includes: Logo on AHCA website event calendar page, Includes all scheduled Forums for the year, Brief presentation during the Forum, Company signage at Forum, Sponsor rep tables, Two attendees from the sponsoring company, Branding on Forum promotional materials.

Silver Sponsor Individual - $1,500 to $4,999
Includes: Brief presentation during the Forum, Company signage at Forum, Sponsor rep tables, Two attendees from the sponsoring company, Branding on Forum promotional materials.

Bronze Sponsor - $1000 to $1,499
Includes: Sponsor rep tables, Two attendees from the sponsoring company, Branding on Forum promotional materials.

AHCA Quality Forums Sponsorship Amount:*

Seminars/Workshops Sponsorship:

$1,000
Includes: Exhibit space, Two attendees from the sponsoring company, Brief presentation during the session, Program acknowledgement, Logo on seminar/workshop materials.

AHCA Seminars/Workshops Sponsorship Amount:*

TOTAL:

$0.00

How Would You Like to Pay?*

Invoice
Credit Card

Credit Card payments will be processed through Authorize.NET.

Credit Card:*

American Express

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Sponsorship Opportunities

Quality Forums Sponsorship:

Seminars/Workshops Sponsorship: