APPLICATION FOR - NAMSS



APPLICATION FOR VENDOR FAIR 2018 SPRING CONFERENCEHilton Easton Columbus, Ohio March 22, 2018COMPANY REPRESENTATIVE(S)COMPANY NAMECOMPANY ADDRESSTELEPHONEFAXEMAIL ADDRESSTYPE OF PRODUCT TO BE DISPLAYEDMy organization would like to provide sponsorship at the following level:?Platinum Level $750: Sponsorship, Signage, # 8-foot table(s) & electric reservation. We need internet access: ? YES ? NO?Gold Level $500: Signage, # 8-foot table(s) & electric reservation. We need internet access: ? YES ? NO?Silver Level $300: # 8-foot table(s) & electric reservation. We need internet access: ? YES ? NO?Bronze Level $100: Unmanned brochure table.?I will have a Table Raffle the day of conference (optional)? By NOT checking the box, I hereby give my consent to include picture(s) of me that may be taken during an OAMSS event that may be used to promote the organization on the website () and do hereby release OAMSS from any liability or legal action for use of said photos.DEADLINE FOR SUBMISSION: Friday, March 8, 2018 Please return this form, along with your check (payable to OAMSS) to:Julie Simmons, CPMSM, CPCSMercy Health - West Hospital3300 Mercy Health Blvd.Cincinnati, OH 45211***To expedite your request, please scan and email all paperwork to jssimmons@*** ................
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