ALPHA 2020 - Sponsorship Form

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* 1. Please enter the following information:

Company Name:

Contact Name:

Mailing Address:

City, State, Zip:

Email Address:

Phone:

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* 2. Please indicate your benefit level of interest:

Denali Level ($10,000 or higher) includes:
- Signage at hotel and listed in conference materials
- Organizational ALPHA membership
- 3 complimentary conference registrations
- Organization description in conference program
- Exhibit space
- Recognition of sponsorship on ALPHA website

Foraker Level ($5,000 - $9,999) includes:
- Signage at hotel and listed in conference materials
- Organizational ALPHA membership
- 2 complimentary conference registrations
- Organization description in conference program
- Exhibit space
- Recognition of sponsorship on ALPHA website

Fairweather Level ($2,500 - $4,999) includes:
- Signage at hotel and listed in conference materials
- Organizational ALPHA membership
- 1 complimentary conference registrations
- Organization description in conference program
- Exhibit space
- Recognition of sponsorship on ALPHA website

Marathon Level ($1,000 - $2,499) includes:
- Signage in conference materials
- 1 complimentary conference registrations
- Organization description in conference program
- Exhibit space
- Recognition of sponsorship on ALPHA website

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* 3. Description of your organization for the program (max of 200 words):

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* 4. Your sponsorship includes one exhibit table with wifi and electrical plug ins. Please Answer the questions below or answer "no table" if you are not planning for an exhibit table:

No Table

Person responsible for table set up:

Phone:

Email:

Person responsible for staffing table:

Cell phone:

Email:

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* 5. For Denali, Foraker and Fairweather Levels, your sponsorship includes an Organization Membership. Let us know the email address to which you would like ALPHA information sent.

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* 6. For Denali Sponsorship, please list name, company and title for up to three free registrations.

For Foraker Sponsorship, please list name, company and title for up to two free registrations.

For Fairweather and Marathon sponsorship, please list name, company and title for one free registration.

Name, Company, Title

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* 7. Upon acceptance by ALPHA, this agreement will become a contract between the sponsor and ALPHA for the Alaska Health Summit. The sponsoring organization and its representatives agree to abide by the information listed.

Authorized Representative:

Date:

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* 8. Payment in full must be received to finalize this Sponsorship contract. This is non-refundable.
If paying by credit card, click on this link to PayPal.

If paying by check, mail check to Information Insights, PO Box 83070, Fairbanks, AK 99708 (must be received prior to event)

I am paying by PayPal.

I am paying by check.

ALPHA 2020 - Sponsorship Form

Question Title

* 1. Please enter the following information:

Question Title

* 2. Please indicate your benefit level of interest:

Question Title

* 3. Description of your organization for the program (max of 200 words):

Question Title

* 4. Your sponsorship includes one exhibit table with wifi and electrical plug ins. Please Answer the questions below or answer "no table" if you are not planning for an exhibit table:

Question Title

* 5. For Denali, Foraker and Fairweather Levels, your sponsorship includes an Organization Membership. Let us know the email address to which you would like ALPHA information sent.

Question Title

* 6. For Denali Sponsorship, please list name, company and title for up to three free registrations.For Foraker Sponsorship, please list name, company and title for up to two free registrations.For Fairweather and Marathon sponsorship, please list name, company and title for one free registration.

Question Title

* 7. Upon acceptance by ALPHA, this agreement will become a contract between the sponsor and ALPHA for the Alaska Health Summit. The sponsoring organization and its representatives agree to abide by the information listed.

Question Title

* 8. Payment in full must be received to finalize this Sponsorship contract. This is non-refundable.If paying by credit card, click on this link to PayPal. If paying by check, mail check to Information Insights, PO Box 83070, Fairbanks, AK 99708 (must be received prior to event)

Question Title

* 9. Exact amount of sponsorship:

* 8. Payment in full must be received to finalize this Sponsorship contract. This is non-refundable.
If paying by credit card, click on this link to PayPal.

If paying by check, mail check to Information Insights, PO Box 83070, Fairbanks, AK 99708 (must be received prior to event)