Vendor Registration

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 geri@kdafirm.com

Company *

Contact First Name *

Contact Last Name *

Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Please select the item that best describes your products or services. *

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. Click here 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.

	First Name	Last Name	Email Address
1	First Name	Last Name	Email Address
2	First Name	Last Name	Email Address
3	First Name	Last Name	Email Address
4	First Name	Last Name	Email Address

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.

COVID-19 *

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.

Current Total:

$0.00