2025 KAP Symposium Sponsorship Commitment Form

By completing this form, you are committing to financial sponsorship of the 2025 KAP Symposium.

The Kentucky Asthma Partnership was formed in 2007 to become a statewide organization dedicated to decreasing the burden of asthma in Kentucky. In 2018 the KAP completed the process to become a 501(c)(3) so any donations made to the Kentucky Asthma Partnership are now tax deductible.

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* 1. Please select a sponsorship level

Gold Sponsor: $2,500 (includes 4 complimentary registrations)

Silver Sponsor: $1,500 (includes 3 complimentary registrations)

Bronze Sponsor: $1,000 (includes 2 complimentary registrations)

Exhibitor: $500 (includes 1 complimentary registration)

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* 2. For your complimentary registrations, please enter the name and email address of each person who will be in attendance (leave blank if no one from your organization will be in attendance).

Registration 1:

Registration 2

Registration 3

Registration 4

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* 3. Sponsor Information

Organization Name *

Address

City

State

ZIP Code

Website

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* 4. Contact Information

Contact Name *

Contact Title

Phone Number

Email Address *

Re-enter Email Address

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* 5. Please upload your company logo here.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 6. Exhibit Booth Information:

Yes, our organization will participate as an exhibitor on the day of the event.

No, our organization will not participate as an exhibitor on the day of the event.

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* 7. If you answered yes to question #5, please choose one:

Yes, we will need electricity

No, we will not need electricity

Payment Information
Tax ID number is 61-1898434

All payments must be received prior to the symposium.

Please submit payment to:
Kentucky Asthma Partnership
Attn: Kentucky Asthma Symposium
P.O. Box 4176
Frankfort, KY 40604

Please make checks payable to the Kentucky Asthma Partnership.

For more information contact: Kentucky.Asthma@ky.gov

Thank you for supporting the Kentucky Asthma Partnership.