Vendor Registration

Thank you for registering to participate in the Annual IPMA Fall Convention. For assistance, contact the IPMA office at inpma@indianapodiatric.org or 888-330-5589.

Contact First Name *

Contact Last Name *

Company Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Please indicate which categories best describe your products and/or services. (Check all that apply) *

Vendor/Exhibit Registration

Standard Convention Sponsor ($600)

Premium Convention Sponsor ($800)

Registration Code (if applicable)

Other Sponsorships

Advertising for On-site Program

On-site Representative First Name *

On-site Representative Last Name *

On-site Representative Email Address *

Friday Lunch *

List any company that you prefer your table is not next to at the convention. Requests will be honored, if possible.

Will you need electricity? *

Yes

No

Cancellation Policy *

Requests for refunds must be made in writing to IPMA. Cancellations made prior to September 14, 2022, will be refunded minus a processing fee of $40.

Current Total:

$0.00