Sponsor Registration Form

3rd Annual SUMMIT Conference Series Coeur dAlene, Idaho May 7th-9th, 2015
-Held at the CDA Resort-

Sponsor Name: _______________________________________________

This name will be printed on signs, t-shirts, and general/breakout sessions

Address: ______________________________________________________________________
Contact Person: _____________________ Telephone: _________________________________
Email Address: _________________________________________________________________
Mandatory
Full Name of Sponsors Staff who will be onsite for the event: ____________________________
Onsite Staff Email Address: _______________________________________________________
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**NEW Guardian Level (Description below)

$5,000.00
Platinum Level (Description below)
$1,000.00(+)
Gold Level (Description below)
$500.00
Silver Level (Description below)
$250.00
PreCon Session Sponsorship (list your preferred PreCon) ____________________ $500.00
Individual Option Sponsorship (list your preferred option) ____________________ $500.00

Please register the above named company for:

Place an X below

(list your preferred

PreCon)
(list your preferred option)

AMOUNT
Guardian Level
Platinum Level
Gold Level
Silver Level

$5,000.00
$1,000.00(+)
$500.00
$250.00

PreCon Session

$500.00

Individual Option

$_______
Total

We understand and agree to the sponsorship guidelines and have enclosed sponsorship fees
according to fee schedule.
Authorized Signature: ________________________________ Date: _____________________
Credit Card: MC / VISA / AMEX # _____________________________ Exp. Date ___________
Name as it appear on Credit Card _____________________________ CVV Code ___________

MAKE CHECKS PAYABLE TO:

(Mail completed form to):

EMS Associates
Framework Meetings and Destinations
Attn: The SUMMIT in Coeur dAlene Registration
2192 E. Grandview Drive
Coeur dAlene ID 83815

Please mail registration form and check/CC data to the address (above) no later than March 2nd, 2015.
If interested in SPONSORING, please apply early. If you have any questions or concerns, please contact:
Nick Lewis (425.381.3103). Once your registration has been received, you will receive an email confirmation.

Date received: ___________________


Sponsorship Descriptions
Guardian Level Sponsor: $5,000.00 (exclusive opportunity)
**Premier (choice selection) Single Booth (1) 6 draped table - with immediate surround, (2)
chairs waste basket, recognition in attendee communication documents and mobile app map
feature
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Logo on conference Tee shirts

General Session acknowledgement/Logo
Website logo/mention and link
Recognition in attendee communication documents
Company logo and link on EMS Associates website and Facebook
Full page ad in printed conference program
Upgraded inclusion on conference mobile app
EMS Associates e-blast message recognizing your companys support of the industry

Platinum Sponsor: $1,000.00(+)

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Logo on conference Tee shirts

General Session acknowledgement/Logo
Website logo/mention and link
1 (full page) ad in program
$350.00 option to be exhibitor

Gold Sponsor: $500.00

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Breakout session door signs

Website Mention
1/2 page ad
$450.00 option to be exhibitor

Silver Sponsor: $250.00

o 1/4 page ad in program
o Coffee Sponsor
o $550.00 option to be exhibitor

Individual Options (specify on form)

PreCons- $500.00
Food and Beverage- $500.00
Equipment Sponsor- AEDs, BVM, bags, manikins, pens
Registration/Check in sponsor- card jackets, desk signs $150.00