DATE

Dear :

Montana State Fund and St. Vincent Healthcare are jointly providing the Montana State Fund Annual Medical Conference in Helena, MT on November 6, 2015. We are writing to invite your company to consider being a sponsor, exhibitor, and opportunity to advertise. Montana State Fund is limiting sponsorship opportunities to entities that do not have a commercial interest, as defined by the Accreditation Council for Continuing Medical Education (ACCME). For information about ACCME’s definition of an entity which has a commercial interest, please click here.

Our theme this year is Injury to Chronic Pain – Changing the Trajectory

We would very much appreciate your sponsorship at this conference. Your company name would be listed as a sponsor on the conference disclosure form and we will schedule break time for attendees to visit the exhibit area.

If you decide to participate as a sponsor, and do not have commercial interest as defined by the ACCME, please complete the enclosed registration form and return to me no later than October 16, 2015. All checks should be made out to Montana State Fund. The tax identification number for the Montana State Fund is 81-0302402. If you have questions, require further information, need to provide further information about your company, please contact me at 406-495-5245. If you have no questions you may simply return the attached form with payment. Sponsorship payment can also be made online through our website montanastatefund.com/

Thank you for your consideration. Your participation would be greatly appreciated by the planning committee and event participants.

Sincerely,

Jacob Marchi

Montana State Fund

PO Box 4759

Helena MT 59604-4759

406-495-5245

Montana State Fund Annual Medical Conference

Injury to Chronic Pain – Changing the Trajectory

November 6, 2015

This sponsorship agreement is for organizations that do not have a commercial interest as defined by the Accreditation Council for Continuing Medical Education (ACCME)

Sponsor Registration

If you are planning on participating, please complete the following:

___ Platinum Sponsor $4,500.00

___ Gold Sponsor$3,500.00

___ Silver Sponsor$2,500.00

___ Exhibitor $500.00

___ Contributor Advertisement $250- ¼ pg. ad., $500- ½ pg. ad.

FIRM NAME ______

(List name as you would like it to appear on all acknowledgements)

Conference contact name ______

Daytime Phone:______Cell #:______Fax: ______e-mail: ______

Mailing Address ______

City ______State ______Zip ______

Please sign below

Sponsor/Exhibitor Agreement

The sponsor/exhibitor agrees to abide by the ACCME’s Standards for Commercial Support of Continuing Medical Education. Note: No promotional exhibits will be displayed in the same room as the educational activity. The display area will be closed during educational activities.

Authorized Signature ______Date: ______

For questions please contact Jacob Marchi 406-495-5245, Jacqui Garcia 406-495-5191, or Patricia McCullough, 406-495-5277

Platinum level sponsors will have a full page ad in our program, receive two free registrations to the conference and Welcome Reception, and will be listed as a sponsor of either the Welcome Reception, a meal, or other event/item as available, and will be provided space for a display booth. Platinum sponsors will have their company logo appear on future conference correspondence sent to potential conference attendees. Sponsors will be acknowledged in our program, are invited to supply marketing and product demo materials for distribution to conference attendees, and will be formally acknowledged at the commencement and conclusion of the conference.

Gold level sponsors will have a full page ad in our program, receive one free registration to the conference and Welcome Reception, will be recognized for sponsoring a meal or break, and will be provided space for a display booth. Sponsors will be acknowledged in our program, are invited to supply marketing and product demo materials for distribution to conference attendees, and will be formally acknowledged at the commencement and conclusion of the conference.

Silver level sponsors will have a half page ad in our program and be provided space for a display booth. Sponsors will be acknowledged in our program, are invited to supply marketing and product demo materials for distribution to conference attendees, and will be formally acknowledged at the commencement and conclusion of the conference.

Exhibitor will be provided with a space for a display booth and are invited to supply marketing and product demo materials for distribution to conference attendees.

Contributor level sponsors will be acknowledged in the program with a ¼ page ad or ½ page ad.

Please note: You become a ‘Sponsor’ only after payment and sponsorship form are received by Montana State Fund. Sponsorships (and sponsored events) are on a first-come, first-serve basis.