Sponsorship Request Form - Wisconsin Healthcare Engineering Association

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Today's Date*

Organization Name:*

Contact Name:*

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Address*

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Phone*

Email*

Price*

Platinum Sponsorship - $5,000.00

Gold Sponsorship - $2,500.00

Silver Sponsorship - $1,000.00

Sponsorship is not guaranteed, you must first be confirmed through the Sponsorship Committee. If you register with a credit card, your card will be charged. You will be notified if you have been accepted as a sponsor by the end of the year.

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