2023 ISHA Conference Sponsor and Exhibitor Registration

Name*

First Last

Title

Institution*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email*

Phone Number*

Are you the person attending the conference?*

If someone else is attending on your behalf please provide their contact information below.

Name

First Last

Email

Sponsorship Level*

Do you intend on being an exhibitor?*

Required information for exhibitors will be sent separately.

Do you intend to supply promotional materials for conference tote bag?*

Information regarding deadlines and shipping details will be sent separately.

Are you going to attend the pre-conference trip?

Included with Presenting/Prime/Pre-Conference Trip Sponsors. $125 extra for other sponsors/exhibitors.

Payment Method

invoice can be supplied for either method

Evening of Champions Meal Choice*

Please let us know what your meal choice for EOC

Dietary Restrictions

Other Information