Sponsor Form: "Achieving Health Equity through Growth, Innovation, and Reflection"

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Please be sure to click SUBMIT when your form is complete. You should receive an automatic email from the system when your submission is complete. You will be contacted by Michigan Health Council within 1-2 business days. If you have any questions, please contact Ana Hornburg at 517-908-8229 or ana.hornburg@mhc.org

Registrations after September 30, 2021 are non-refundable.

Email *

Main Contact Information

Please complete all required information for the main contact of this event. The main contact will receive all detailed information regarding the event, including invoice, hotel details, and reminders.

Organization name *

Please enter your organization's name as you would like it to appear on all communications (ie. website, conference brochure, etc.). Exhibitors may not share or sublease table space with other organizations.

Name *

Please name the person who will receive all details and information

Title *

Fellow contacts

Please list the names and emails of any others at your organization who will need access to the event (maximum of 3).

Phone number *

Complete Billing Address (street, city, state, zip) *

Exhibiting & Sponsorship Details

Which sponsorship level are you participating as? *

Organizations who have exhibited previously with the Michigan Nursing Summit (2014-2019) are eligible to receive a $100 discount on the listed pricing for all sponsorship levels.

Bronze Sponsor ($800)

Silver Sponsor ($1,500)

Gold Sponsor ($3,000)

Platinum Sponsor ($5,000)

Custom package (Call Ana @ 517-908-8229)

Payment information

Payment preference *

You may pay your invoice by credit card or check. Please send a check payable to Michigan Health Council, 2121 University Park Drive, Suite 150, Okemos, MI 48864. Reference "2021 MCN Sponsor". All payments must be received by October 1, 2021.

I will pay with a credit card electronically

I will mail a check to the above address. Reference "2021 Nursing Sponsor" on the check.

Additional comments:

if you have any additional comments or questions, please enter them here.

How did you hear of the Michigan Nursing Summit?

Your successful submission will trigger an automatic email response. If you do not receive an automatic email, please contact Ana Hornburg at ana.hornburg@mhc.org or 517-908-8229 at your earliest convenience. Registrations after Sept 30, 2021 are non-refundable.

A copy of your responses will be emailed to the address you provided.

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