Exhibitor Application



-457200-32004000Massachusetts Association of Public Health Nurses“Many Hats of the Public Health Nurse”24th Annual Public Health Nursing ConferenceSouthbridge Hotel and Conference Center14 Mechanic Street Southbridge, MassachusettsMay 7th, 2020 8:00 a.m. to 3:00 p.m.(Exhibitor set-up may begin at 7:15 a.m. and Exhibitor Name Badges will be provided) FORMCHECKBOX $1,500 Corporate Exhibitor FORMCHECKBOX $85 Local Exhibitor*Name acknowledgement at ConferenceName listed on Conference Exhibitor MapListing on Conference Exhibitor MapConference Plenary and Website ListingConference Plenary and Website Listing One Full Exhibitor Table at ConferenceOne Full Exhibitor Table at ConferenceExecutive BreakfastExecutive Breakfast One Lunch at Conference**Two lunches at Conference(*Local Crafter or independent business without employees) FORMCHECKBOX $500 Small Business* Exhibitor FORMCHECKBOX $40 MDPH State Coalition PartnerName acknowledgement at ConferenceName listed on Conference Exhibitor MapListing on Conference Exhibitor MapConference Plenary and Website ListingConference Plenary and Website ListingOne Full Exhibitor Table at ConferenceOne Full Exhibitor Table at ConferenceExecutive BreakfastExecutive BreakfastOne Lunch at Conference**One lunch at Conference**(*fewer than 25 employees) FORMCHECKBOX $350 University/ CollegeName listed on Conference Exhibitor MapConference Plenary and Website ListingOne Half Exhibitor Table at ConferenceExecutive BreakfastOne lunch at Conference****Each additional lunch will be $25.00 and must be paid when Exhibitor form and payment submitted**Please complete and email to president@ or print and mail this form and check payable to: MAPHN PO Box 537Milton, MA 021861-617-291-7541president@501 c-3 organizationTax ID Number 04-3436791 MAPHN PO Box 537Milton, MA 021861-617-291-7541president@Name of person(s) staffing Exhibit table: FORMTEXT ?????Name of contact (if different from person staffing table): FORMTEXT ?????Organization: FORMTEXT ?????Address: FORMTEXT ????? City: FORMTEXT ?????State: FORMTEXT ????? _Zip: FORMTEXT ?????Phone: FORMTEXT ????? E-mail: FORMTEXT ?????Amount enclosed FORMTEXT ????? ................
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