2018 NCHN Conference Exhibitor Application
All prospective exhibitors must complete the application form.

  • 2018 NCHN Conference Exhibitor Opportunitiy

    Please join us this year in our mission to support and strengthen health networks. Your presence exhibiting enables NCHN to serve its nationwide membership, supporting their efforts to improve healthcare access and services across the country. For more details please contact Larry Bedell at lbedell@nchn.org
  • Exact name of organization for listing and signage
  • NCHN reserves the option to edit your description if it exceeds available space on the website or program (Recommended: 250 words or less).

  • Company Logo

    High resolution (300dpi) logos, must be received by April 3, 2018.

    Please enter the information below as you would like for it to appear on the conference website and in the mobile event app.

  • NOTE: If you do not upload a logo, please email a high resolution (300dpi) png or jpg copy to lweiss@nchn.org as soon as possible to have it displayed in the appropriate locations.

  • Contact Information

    Please include the contact information for the exhibiting organization below.
  • This will be the email address NCHN uses to correspond with you.
  • - -

  • Booth Representative(s)

    Please include name, and email address of any representative(s) attending the conference. The exhibit fee includes one complimentary conference registration. (Additional representatives may attend for an additional fee. Information is under the Payment section.)
  • Name Title Email
    Complimentary Rep. 1
    Additional Rep. 1 ($549)
    Additional Rep. 2 ($549)

  • Exhibit Rate and Payment

    You may pay by check or by credit card via PayPal. ($35 fee required for credit card payment)

    EXHIBIT RATE
    $949, which includes 1 representative. Additional representatives may attend for an additional $549 each to cover the cost of meals, breaks & Wednesday evening networking event.

    Check Rate: Exhibit fee = $949, Additional Representatives = $549/each
    PayPal Rate: Exhibit fee = $984, Additional Representatives = $584/each

    BUSINESS PARTNER EXHIBIT RATE
    $0 for one representative
    Check Rate: $499 for an additional representative
    $549/each (for additional reps after 1)
    PayPal Rate: $534/each (an additional representative),
    $584/each (for additional reps after 1)

    If paying by check, please make the check payable to NCHN and mail to:
    NCHN (National Cooperative of Health Networks Association)
    c/o Rebecca J. Davis
    400 South Main St.
    Hardinsburg, KY 40143

    If paying by PayPal, please use the PayPal link on the page you will be redirected to after successful submission of this application.

  • Terms & Cancellation

    ACCEPTANCE OF APPLICATION AND ASSIGNMENT OF SPACE
    Applications for exhibit space are subject to review by NCHN's Conference Planning Committee. Space assignments will be based on NCHN Business Partner status, number of years of prior NCHN sponsorship and then on a first-paid basis. No assignments will be made until payment is received. The 2018 Conference Planning Committee reserves the right to make such changes to the floor plan of displays as may be deemed necessary. Applications should be received by March 26, 2018. Those received after this deadline or after space is filled, will be placed on a waiting list and will be notified if space becomes available.

    PAYMENT AND CANCELLATIONS
    Exhibitor Applications must be accompanied with the exhibitor fee in order to confirm display space. No application will be processed without this fee. No refunds will be made for space not utilized during the conference. The 2018 Conference Planning Committee retains the option of returning funds.

    COMMUNICATION
    By providing your contact information, you authorize the National Cooperative of Health Networks to communicate with you regarding event information and to process your application.

    If you have any questions about this form or planning your exhibit, please contact Linda K. Weiss at 217-549-4121 or lweiss@nchn.org

    If you have questions about future exhibit and sponsorship opportunities, please contact Larry Bedell at lbedell@nchn.org