HMEIC Sponsorship Form "*" indicates required fields Company Name* Company Contact* First Name Last Name Company Contact Title* Company Contact Email* Company Website* Company DescriptionSocial Media URLs Add RemoveSponsorship Opportunities*Select one…Diamond – $15,000 (1 remaining)Platinum – $10,000 (0 remaining)Gold – $7,500 (0 remaining)Silver – $5,000Bronze – $2,500Publicity and Outreach Sponsorship – $3,500 (1 remaining)Delegate Notepad – $3,500 (0 remaining)Delegate Pens – $3,500 (0 remaining)Interactive Mobile App – $3,500 (0 remaining)Wi-Fi – $3,500 (0 remaining)Charging Station – $3,500 (0 remaining)Photo Booth Station – $3,500 (1 remaining)Charitable DonationDiamond Sponsorship RegistrantsAdd up to 8 additional registrationsFirst NameLast NameTitleEmail Add RemovePlatinum Sponsorship RegistrantsAdd up to 6 additional registrationsFirst NameLast NameTitleEmail Add RemoveGold Sponsorship RegistrantsAdd up to 4 additional registrantsFirst NameLast NameTitleEmail Add RemoveSilver Sponsorship RegistrantsAdd up to 2 additional registrantsFirst NameLast NameTitleEmail Add RemoveBronze Sponsorship RegistrantsAdd up to 1 additional registrantFirst NameLast NameTitleEmailCharitable Donation Amount*Additional RegistrantAdd up to 1 additional registrantFirst NameLast NameTitleEmailCompany LogoIf you are experiencing issues uploading your logo files, please email Lisa Chines and Nikki Howes at lmctaur@gmail.com and nikki.howes@epicbrokers.comAccepted file types: ai, eps, Max. file size: 100 MB.Method of Payment*Payment instructions will be sent to the email address you have provided. Wire Transfer Check Payment Agreement* I understand that my Sponsorship selection is not guaranteed until payment has been made, and that instructions on how to submit payment will be sent to me via the email address provided above.Special Requests or Additional Information
