DNA Sponsorship Form - 2022 Nurses' Night at the Blue Rocks

Sponsor Information

Please fill out the below information that will be used for marketing and communications related to the 2022 Nurses' Night at the Wilmington Blue Rocks, hosted by the Delaware Nurses Association (DNA).

For questions, please contact DNA's Executive Director, Christopher E. Otto, MSN, RN, CHFN, PCCN, CCRN. executivedirector@denurses.org or 302-733-5880.

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* 1. Sponsor Organization's Name (as will be displayed on materials).

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* 2. Sponsor Organization's Logo (as will be displayed on materials).

Please upload your organization's logo.

PDF, PNG, JPG, JPEG file types only.

Choose File

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* 3. Sponsor Organization's Website (url that you would like DNA contacts to be directed to).

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* 4. Sponsor Organization Contact Information (primary person who will be communicating with/representing the sponsor organization).

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 5. By completing this form and submitting sponsorship payment, I certify that I am an authorized representative of the sponsor organization and will communicate with DNA staff regarding the event and any follow-up.

I agree.