WIAAP Exhibitor/Supporter Application

Athlete 360° - November 11, 2022, 2022

Thank you for your participation in WIAAP's 2022 Open Forum.

We encourage you to promote the conference in your networks! Information and conference registration can be found at athlete360.eventbrite.com and our website at wiaap.org.

Please have each booth staff member register via that link to ensure we have nametags, food counts and any specific needs or accommodations.

Please contact Rishelle Eithun, reithun@wiaap.org, 608.395.9368, with any questions.

(WIAAP's tax ID is #31-1535272; certificate available by request.)

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* 1. Primary contact information

Contact Name

Organization Name

Billing Address

Address Line 2 (optional)

City/Town

State/Province

ZIP/Postal Code

Email address

Cell phone number

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* 2. Level of support

Forum Champion ($4,000)

Forum Collaborator ($2,000)

Forum Supporter ($1,000)

Forum Advocate ($500)

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* 3. Credit card information (Visa/MC, American Express)

Name on card (if different from primary contact name)

Card number

Expiration date XX/YY

CVV / Security Code

Billing address:

WIAAP Exhibitor/Supporter Application

Athlete 360° - November 11, 2022, 2022

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* 1. Primary contact information

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* 2. Level of support

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* 3. Credit card information (Visa/MC, American Express)

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* 4. Checks - mail to WIAAP, PO Box 243, Oconomowoc, WI 53066 (include check number, if available).

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* 5. Contact for promotional/artwork needs (name and email address)

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* 6. Do you require any other accommodations?