Welcome to Iowa MGMA & Thank You for your Sponsorship!
Welcome to Iowa MGMA & Thank You for your Sponsorship! The mission of Iowa MGMA is to improve healthcare and help our members 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.
☐ Annual Silver Sponsor
$1850
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.
☐ 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 Dates Spring 2017 – April 19 – 21, Hilton DoubleTree – Cedar Rapids Fall 2017 – September 20 – 22, The Gateway - Ames
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
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
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
☐ 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.
☐ Annual Silver Sponsor
$1850
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.
☐ 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 Dates Spring 2017 – April 19 – 21, Hilton DoubleTree – Cedar Rapids Fall 2017 – September 20 – 22, The Gateway - Ames
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
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
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
