Please complete this form to register your sponsorship and virtual exhibit booth for the Great Lakes Conference. Once your registration is received, you will be contacted to begin preparing for your participation in the conference. For assistance, please contact Geri Root, MPMA Director of Events, 517-999-8751 or firstname.lastname@example.org
Contact First Name
Contact Last Name
Please select the item that best describes your products or services.
Billing Software or Services
Chairs and Other Podiatric Equipment
Electronic Medical Record
Implants and Surgical Devices
Laboratory and Diagnostic Services
Orthotics and Corrective Devices
If you selected "other," please describe
Great Lakes Conference Exhibit and Corporate Partnership
Conference Exhibitor ($900)
Bronze Corporate Partner ($1,200)
Silver Corporate Partner ($3,000)
Gold Corporate Partner ($4,500)
Platinum Corporate Partner ($7,000)
Diamond Corporate Partner ($10,000)
Preferred Booth Location
Booth assignments will be made by MPMA. Please enter your top 5 location choices below. Booth requests will be made on a first-come, first-served basis upon receipt of registration and full payment.
to view exhibit diagram.
Preferred Location 1
Preferred Location 2
Preferred Location 3
Preferred Location 4
Preferred Location 5
Company Representatives Registration
You may register up to 4 company representatives to staff your booth. The first 2 representatives are complimentary. Each additional represenative is $50.
How many representatives would you like to register?
1 Representative (Complimentary)
2 Representatives (Complimentary)
3 Representatives ($50)
4 Representatives ($100)
Please complete the following for the representatives you are registering.
Do you need electricity?
Yes - Electricity ($60)
No - Electricity
Company Insert in Registration Materials
Company Insert - Conference Exhibitor ($100)
Company Insert - Corporate Partner (Complimentary)
Conference Program Advertisement
Full Page Ad ($500)
Half Page Ad ($300)
Conference Program Advertisement - Conference Exhibitor
Full Page Ad ($375 - discounted rate)
Half Page Ad ($225 - discounted rate)
Conference Program Advertisement - Bronze, Silver, Gold Corporate Partners
Full Page Ad ($200 - discounted rate)
Half Page Ad (Complimentary)
Conference Program Advertisement - Platinum and Diamond Corporate Partners
Full Page Ad (Complimentary)
Additional Sponsor Opportunities
Many of these sponsor opportunities have only one opportunity available. You will be contacted to confirm the sponsorship. If you have questions about availability, please contact the MPMA office.
Registration Bag ($1,500)
Registration Bag (donated in-kind)
Lanyards (donated in-kind)
Notepads (donated in-kind)
Pens (donated in-kind)
Acknowledging that there is an ongoing health crisis across the country related to the COVID-19 pandemic, I agree that by registering for the 2022 Great Lakes Conference in Dearborn, Michigan, I assume the inherent risk of exposure to COVID-19 that exists by visiting any public place where other people are present. I hereby indemnify and hold harmless Michigan Podiatric Medical Association, its volunteers, employees, and others working on behalf of the Michigan Podiatric Medical Association, against any and all claims, demands, suits, or loss, including all costs connected therewith, and for any damages which may be asserted, claimed, or recovered against or from Michigan Podiatric Medical Association, including loss of life, as a result of the pandemic.