Iowa MGMA Sponsorship Application

Iowa MGMA Sponsorship Application The mission of Iowa MGMA is to improve healthcare and help our members who are medical group managers, and their practices succeed through education, networking and advocacy. The Iowa Medical Group Management Association (IMGMA) is a non-profit organization of over 300 members dedicated to quality health care management. IMGMA assists the members to develop effective and efficient best practice methods, thus enhancing the provision of quality healthcare services within Iowa.

☐ Annual Gold Sponsor

$3500

Includes Spring & Fall Exhibits, conference attendee list, 4 affiliate memberships, 3 additional attendees per conference, electricity & Wi-Fi, access to online member database, preferred booth space and first choice selection of booth space, annual speaker presentation opportunity, name listed as Gold sponsor on program materials, bi-annual list of members in excel format, distinct recognition at conferences, name in quarterly newsletter. New in 2018: Panel of Payers Exhibit, Conference scholarship for one attendee (member or nonmember)

☐ Annual Silver Sponsor

$2250

Includes Spring & Fall Exhibit, conference attendee list, 2 affiliate memberships, 2 additional attendees per conference, electricity & Wi-Fi, access to online member database, preferred booth space. New in 2018: Discounted Panel of Payer Exhibit

☐ Event Sponsor – Keynote Speaker

$2000

Name on signage and listed on all conference materials, introduction of speaker, short message about sponsor organization

☐ Evening Reception

$2000

Name on signage and listed on all conference materials, four complimentary tickets to even (as applicable)

☐ Name Badge Sponsor

$1500

Sponsor logo on conference attendee name badges

☐ Conference Speaker

$750

Name on signage and listed on all conference materials, four complimentary tickets to even (as applicable)

☐ Coffee/Beverage Break Sponsor

$500

Name on signage and listed on all conference materials, four complimentary tickets to even (as applicable)

Conference/Event Dates* Spring Conference 2018 – April 18 – 20 Panel of Payers – June 14 Fall Conference 2018 – September 12 - 14 *All 2018 events to be held at Hilton Garden Inn – West Des Moines

Innovation through Opportunities Wisdom and Action 9466 Deer Valley Dr  Cedar Rapids, IA 52411  p:319.560.0435  f: 319.774.5661  imgma.org

Iowa MGMA Sponsorship Application Organization Primary Contact Information: First Name: Last Name: Title: Organization: Address: Address 2: City/State/Zip: Phone: Mobile Phone: Fax: Email Address: Services Provided:

☐ Gold

Sponsorship:

☐ Silver

☐ Keynote

☐ Reception

☐ Name Badge ☐ Conference Speaker ☐ Coffee Break Website url: Gold – List Additional 3 Affiliate Members Silver – List 1 additional Affiliate Member

Innovation through Opportunities Wisdom and Action 9466 Deer Valley Dr  Cedar Rapids, IA 52411  p:319.560.0435  f: 319.774.5661  imgma.org

Iowa MGMA Sponsorship Application PAYMENT OPTIONS ☐

Register and Pay Online (Credit card only) Website: www.imgma.org – Sponsorship Opportunities

☐

Check Included (Payable to Iowa MGMA) Mail Check and copy of application To:

☐

IMGMA Executive Director 9466 Deer Valley Drive Cedar Rapids, IA 52411

Fax this form to: 319-774-5661 Credit Card (please circle one and complete all fields below) Visa

MasterCard

American Express

Discover

Name on Credit Card: Billing Address: City/State/Zip: Card Number: Expiration Date: Month __________

Year _________

CVC Code: Email Address: Signature (Authorization of Charges): Amount Authorized:

Innovation through Opportunities Wisdom and Action 9466 Deer Valley Dr  Cedar Rapids, IA 52411  p:319.560.0435  f: 319.774.5661  imgma.org