2024 Conference Sponsor Registration

Become a 31st Annual Conference Sponsor!

By contributing $3,000 to MMDA, you receive:

• Preferred placement, 6-foot tabletop display with 2 chairs in the exhibit area.
• 150-word description included in the printable digital program.
• One (1) full-page color ad in the printable digital program.
• Four (4) complimentary staff conference registrations – with contact hours for MDs/DOs/NPs/PAs provided.
• Lunch is provided.
• One (1) full-page color ad in digital membership newsletter.

*Sponsorships are subject to the guidelines of the Accreditation Council for Continuing Medical Education (ACCME). We are happy to discuss the specific needs of your organization and help make this a successful exhibitor event. Please contact Shane Bellotti at sbellotti@corecare.net or (561) 689-6321.

Organization Name: *

Contact Person: *

First

Last

Credentials:

Title: *

Email: *

Cell Phone: *

Complete Mailing Address: *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Phone: *

Fax:

Sponsor's representative name badges.
Up to 4 are included, with a $50 charge for each additional representative.

Representative 1:

First

Last

Representative 2:

First

Last

Representative 3:

First

Last

Representative 4:

First

Last

Payment Information

Sponsor Package: *

• 31st Annual Conference Sponsorship - $3,000.00

Total: *

Order Summary

Item	Quantity	Total
There are no products selected.
Sponsor Package: - 31st Annual Conference Sponsorship	1	$3,000.00
Total		$3,000.00

$0.00

Credit Card: *

Submit