/ SPONSOR & EXHIBITOR APPLICATION & AGREEMENT
Sheraton Memphis Downtown, TN October 15-17, 2015

Begun by the North Carolina Community Health Center Association in 1988, the East Coast Migrant Stream Forum is an annual conference that offers health professionals skills-based trainings and professional development opportunities in the migrant health field. The audience includes outreach workers, front-line staff, healthcare providers, administrators, and other health advocates.

Through workshops and networking opportunities, attendees are exposed to the latest in workforce development skills training, clinical trends, farmworker-specific service delivery models, cutting-edge research, and legislative and funding initiatives.

Package Descriptions

All payments and artwork must be received by September 16, 2015

Platinum Sponsorship Packages $5,500| 3 Opportunities Available

Welcome Reception—Thursday Evening, October 15, 2015

This opening reception sets the stage for the entire conference! All conference participants are invited to mingle, network and have fun while enjoying tasty hors d’oeuvres. As a sponsor you will be given the opportunity to address the entire body and highlight your product.

Keynote Speaker—Friday, October 16, 2015

Help bringa nationally prominentspeaker to the East Coast Migrant Stream Forum! Your support of this year’s Keynote Speaker will help cover travel and/or speaker fees. The KeynoteSpeaker addresses conference attendees at the most highly attended session of the conference. With this option, you can address all participants at the start of the Opening Plenary during lunch.

Conference Padfolio or Conference Bag Sponsorship

Leave an impression on conference participants long after the conference ends! The complementary, high-quality promotional item is designed for long-term use and made available to all attendees at the onsite conference registration desk. Choose this sponsorship option and we’ll place your company’s logo on the outside of the padfolio/bag all participants receive. All artwork must be received by September 16, 2015.

Platinum Sponsors receive:

  • Full-page ad in the conference program.
  • Company name displayed during sponsored event
  • Advanced digital copy of conference participant list
  • One 6-foot skirted table with chairs
  • Two exhibitor registrations

Gold Sponsorship Packages $3,500| 5 Opportunities Available

Breakfast—Friday, October 16, 2015or Saturday, October 17, 2015

Two full-service breakfasts will be provided to conference attendees. Promote your company and help start participants’ day off right by supporting these well-attended events. We will be happy to recognize your support at this event.

Lunch—Friday,October 16, 2015or Saturday, October 17, 2015

Two full-service lunches will be provided to conference participants. These events always have a great turnout and provide an excellent opportunity for companies to network and engage the attention of participants. We will be happy to recognize your support at these events.

Farm Tour—Thursday, October 15, 2015

Unique to the East Coast Migrant Stream Forum is a tour of a local agricultural operation or clinic serving special populations. This tour is always a conference highlight.

Gold Sponsors receive:

  • Half-page ad in the conference program
  • Company name displayed during sponsored event
  • Advanced digital copy of conference participant list
  • One 6-foot skirted table with chairs
  • One exhibitor registration

Silver Sponsorship Packages $2,500| 3 Opportunities Available

Full Snack Refreshment Breaks—FridayMorning, October 16, 2015or FridayAfternoon, October 16, 2015

These snack breaks provide an opportunity for attendees to reenergize. Light refreshments, soda, and tea will be available. You’ll be able to network with participants as they relax during their break. Your agency’s name will be displayed at the snack table.

Nametag Lanyard

Conference attendees will receive a durable lanyard displaying their nametag throughout the length of the entire conference. Choose this option and we’ll print your company’s name or logo on all of conference lanyards. Be seen at all times!

Silver Sponsors receive:

  • Company name in conference program
  • Plenary acknowledgement
  • Advanced digital copy of conference participant list
  • One 6-foot skirted table with chairs
  • One exhibitor registration

Non-Profit Exhibitors$500

Exhibitors receive:

  • Organization name listed in conference program
  • Plenary acknowledgement
  • Advanced digital copy of conference participant list
  • One 6-foot skirted table with chairs
  • One exhibitor registration

Donor

Your donation of any level will help support conference attendance for farmworker promotores(as).

  • Donors who provide a minimum of $500 will receive a half-page ad in the conference program.

Logistics

All payments and artwork must be received by September 16, 2015.

Registration

To register fill out the form below, and return by email or U.S. mail with payment by check or credit card.

Deadlines

All payments and artwork must be received by September 16, 2015 for inclusion in conference materials. Send high resolutionartwork to Steve Smith at .

Hotel Information

Sheraton Memphis Downtown
250 North Main Street
Memphis,Tennessee38103
(901) 527-7300
Reserve a Room
Hotel rate per night: $134. Mention the East Coast Migrant Stream Forum for discounted hotel rate.

Setup

Exhibits may be set up between 3:00 pm – 5:00 pm on Thursday, October 15, 2015. Exhibitors are encouraged to enjoy all meals and network with conference attendees at every opportunity. Please check in at the 2015 East Coast Migrant Stream Forum Registration Desk upon arrival where you’ll receive all conference materials including badge, program, and participant list.

Questions?

Contact Steve Smith, Business Development Manager, at or
(919) 297-0016 for more information on sponsorship opportunities.

Contact Information

Please TYPE all information as you’d like it to appear on printed materials.

Organization/Complete Agency Name:

Address:

City: State: Zip:

Main Contact: (To receive correspondence):

Title:

Phone:Fax:

Email: Organization Website:

Attendees

Representative to receive complimentary registration--based on sponsorship level:

Name Title: Email:

Platinum Sponsors Only Second Representative to receive complimentary registration

Name: Title: Email:

Additional Representatives Attending at rate of $200.00/person:

Name: Title: Email:

Name: Title: Email:

Name: Title: Email:

NCCHCA may document the conference for promotional purposes. Your participation may be filmed or photographed at this event. Registration is consent for use of these images and recordings by NCCHCA.

Facilities

Need an electrical outlet? Yes No (Not guaranteed, but we’ll do our best to accommodate your request.)

Select Your Package Options

PLATINUM SPONSORSHIP $5,500 Welcome Reception Keynote SpeakerConference Padfolio or Conference Bag

GOLD SPONSORSHIP $3,500 Friday Breakfast Saturday Breakfast Friday Lunch

Saturday Lunch Closing Speaker

SILVER SPONSORSHIP $2,500 Friday Morning Full Snack Refreshment Break Saturday Morning Full Snack Refreshment Break

Nametag Lanyard

NON-PROFIT EXHIBITOR $500

DONATION:Enter amount $

ADDITIONAL EXHIBIT REPRESENTATIVES $200/PERSONIndicate quantity

Method of Payment

Payment must accompany agreement to confirm attendance. Agreement, payment and art work must be received by September 16, 2015. NO REFUNDS.

Make checks payable to: North Carolina Community Health Center Association

Please charge my:MasterCardVisa Discover AM/EX

Credit Card Number: Expiration Date: Card Security Code: What’s this?

Name as it appears on credit card:

Billing address:

Billing phone number:

Total Enclosed: $

Signature (required): ______Date:

Return completed form with payment by September 16, 2015:
North Carolina Community Health Center Association
FINANCE DEPARTMENT
4917 Waters Edge Drive, Suite 165
Raleigh, NC 27606
Fax (919) 469-1263 / The North Carolina Community Health Center Association (NCCHCA) wishes to thank all of our sponsors, exhibitors, and speakers for their support. NCCHCA does not endorse specific vendor products or services or any speaker views or opinions shared. NCCHCA is not responsible for content expressed and cannot be held liable for information received.

PLEASE TELL US MORE ABOUT YOURSELF: (Required)

Our primary funder has requested that we obtain the following information for all conference attendees.

How many years have you worked in Farmworker Health?

Less than 1 year1 to 3 years4 to 6 years7 to 10 years11 years or more

How many times have you attended the East Coast Migrant Stream Forum? (Required)
First-time attendeeTwoThree or more

Which category best describes your primary occupation? (Required – Check One)

AdministratorFarmworkerState Primary Care Association Staff

Advocacy/PolicyHealth/Primary Care ProviderResearcher

Behavioral Health ProviderLay Health Worker/Promotor(a)State/Federal Employee

Clinical Support StaffM/CHC Board MemberStudent

Dental ProfessionalOutreach Worker/CoordinatorOther – Please specify:

Executive Director/CEOPractice/Office Manager

North Carolina Community Health Center Association
East Coast Migrant Stream Forum
Page 1 of 4 / 4917 Waters Edge Dr., Suite 165
Raleigh NC 27606
Steve Smith, or (919) 297-0016