2012 Exhibitor, Sponsor & Advertiser Application
Exhibitors, sponsors, and advertisers should complete the form and mail payment by March 15, 2012.

High resolution (300di) logos, advertisements, and folder inserts must be received by March 15, 2012.

Please enter the information below as you would like for it to appear on the Conference website and in the Program.
  • This will be the email address NCHN uses to correspond with you about the Conference.
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  • Exhibitors

    Select your Exhibitor Category below.

    In addition to the Exhibit fee, each booth representative must pay the reduced registration fee ($350/ea.) to cover costs of meals during the conference.
  • Optional: Please let us know if you prefer to have your booth located next to or near a specific organization.
  • Enter the # of tickets for guests of Booth Representatives. Enter 0 if you will not be bringing guests to the reception.
  • Enter the # of tickets for guests of Booth Representatives. Enter 0 if you will not be bringing guests.
  • If any booth representatives will be bringing a guest to the opening reception or Monday night baseball game, please enter the guest name/s.
  • Sponsors

    Select your preferred sponsorship level below. Sponsors are accepted on a first come, first served basis. If a sponsor has already selected your sponsorship event, we will contact you by phone to arrange an alternate event or a refund.
  • Advertisers

    Advertising opportunities are available in the 18th Annual Educational Conference Program. Art work must be high-resolution (300 dpi jpg,pdf, ai, psd) and emailed to csullenberger@nchn.org no later than March 15, 2012.
  • Information for the Website and Conference Program

    All opportunities include logo and acknowledgement in the Conference program and Conference Web site
  • NCHN reserves the option to edit your description if it exceeds available space on the website or conference program (Recommended: 250 words or less).
  • NOTE: If you do not upload a logo, please email a high resolution (300dpi) copy to csullenberger@nchn.org by March 5, 2012 to have it displayed in the appropriate locations
  • Payment

    Check must be received before NCHN can consider your application. Mail payment by March 1, 2012 to:

    NCHN (National Cooperative of Health Networks Association)
    c/o Rebecca J. Davis
    624 South 1st Street
    Montrose, CO 81401
  • REQUIRED: Booth representatives must register for the conference to cover meal costs. The conference registration fee covers the Opening Reception on Sunday night, and meals and breaks on Monday and Tuesday.
  • Note: By providing your contact information, you authorize the National Cooperative of Health Networks to communicate with you regarding event information and to process your registration.
  • Terms & Cancellation

    Note: Full payment must accompany an application for Exhibit space or Sponsorship. Payments must be sent by mail to NCHN, 624 South 1st Street,
    Montrose, CO 81401. Booth assignment will not be made without receipt of payment. Cancellation of exhibit space or sponsorship must be received by the National Cooperative of Health Networks prior to April 1, 2012, to receive a refund (minus a $50 administrative fee).

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

    After submitting your application, you will be redirected to the Sponsor Planning page. If you have any questions about this form or planning, contact Christy Sullenberger at 540-352-2529 or csullenberger@nchn.org
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