Partner Sponsorship – Healthy MS Conference

Register for the 2023 ECHMC Partner Sponsorship

Your logo will not be added to any print work, just online only.

Mississippi State Department of Health Office of Preventive Health, C/O Charlotte Holly, P.O. Box 1700, Jackson, MS 39216-1700

CONTACT US: Phone 877-673-2462 • Fax 877-673-2462 • Email info@healthymsconference.com • Website www.healthymsconference.com

Name *

First

Last

Organization/Business

Address

Address Line 1

City

State

Zip Code

Layout

Phone

Fax

Website

Name of Person Attending Conference *

First

Last

Name of Person Attending Conference

First

Last

Upload Company Logo

Click or drag a file to this area to upload.

Select Partner Sponsorship *

If you are mailing your payment, please let us know which Sponsorship Type and Total you will be selecting.

We must receive all payments and forms in the mail by April 15th.

Stripe Credit Card

Card

Name on Card

Total

$ 0.00