18th Annual

Sponsorship and Exhibitor Opportunities

Friday, May 6, 2016

LOCATION: University of Southern Indiana, University Center, Carter Hall 8600 University Boulevard, Evansville, IN 47712

Who will Attend? Advanced Practice Nurses, Nurses and nurse practitioner students

This is a very popular conference with over 140 nurse practitioners attending last year.

Provided by the University of Southern Indiana and CAPNI Region 4.

Registration – HPR809A

Organization Name
Address
City /State/Zip
Contact Namel
Telephone Number
Email
Name Badge(s)
* Maximum of two (2) name tags per exhibit space.
Parking attendant will be given the names provided above to access preferred exhibitor parking and unloading.
Parking directions will be mailed with exhibitor confirmation.
Please Check One
LUNCHEON SPONSOR$ 750
*Exhibit Table (4 by 6 foot with white table covering) *Your corporate name and logo on and Conference App. *Special signage during your sponsored event & special recognition during the day *Special recognition in the conference brochure if signed commitment received by 02/12/16*One full registration to conference*Two lunches
SPEAKER SPONSOR $ 500
*Exhibit Table (4 by 6 foot with white table covering) *Your corporate name on Conference App. *Special recognition in the conference brochure if signed commitment received by 02/12/16 *Special signage during your sponsored event & special recognition during the day *One full registration to conference*Two lunches
BREAK SPONSOR $ 500
*Exhibit Table (4 by 6 foot with white table covering) ) *Your corporate name on Conference App. *Special recognition in the conference brochure if signed commitment received by 02/12/16 *Special signage during your sponsored event & special recognition during the day *One full registration to conference*Two lunches
__ EXHIBITOR $ 250
Six foot table with tablecloth. *Program acknowledgement.*One full registration to the conference.
_____Electricity requested for exhibit.
(Limited availability. Request in advance of event)
_____Provide attendance prize.
Booths include: one 6' clothed table and two chairs.
PAYMENT –Make payment within 21 days of registration
Check (Make checks payable to: USI) USI Tax ID number: 351308176
Credit Card:  VISA, MASTERCARD DISCOVER AMEX
Card #:
Exp. Date: ____/____
Credit Card Billing Zip Code:
Name on Card:
3 Digit Security Code:
Billing Address: (if different from address given above):

Sponsorship opportunities will be accepted until all places are filled, or May6, 2016 whichever occurs first. NO exhibit registrations will be accepted by phone or email without this completed Sponsorship and Exhibit Opportunities Registration form. Confirmation of your registration will be mailed to you. If your check is not received within 21 days of the confirmation, we will open up the exhibit location for others requesting space.

RETURN by 02/12/16 for inclusion in conference brochure, where applicable

TO: Jennifer Hertel, 8600 University Blvd, Evansville, IN, 47712 • Phone:812/461-5463 • Fax: 812-465-7061 •

Please note that outside food may not be brought in and distributed at your exhibit table; wrapped candy is acceptable.