Name
*
First Name
Last Name
Email Address
*
Organization/Company Name
*
Contact Number
*
(###)
###
####
Alternate Contact Number
(###)
###
####
Tell us a little about your organization/company:
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Is your organization* a local organization offering healthcare or mental health services?
Here, an "organization" can mean any agency, company, association, business, corporation, private practice, etc.
Yes
No
Sponsorship Level
Presenting Sponsor ($1000/$1250 in kind)
Platinum Sponsor ($750/$900in kind)
Gold Sponsor ($500/$650 in kind)
Silver Sponsor ($300/$450 in kind)
Bronze Sponsor ($175/$300 in kind)
Marketing Partner (Promote Stop the Stigma through media, print, TV, and/or radio)
Community Provider ($150) *Only available to local healthcare or mental health related organizations
Individual Sponsor ($35)
Local organizations providing healthcare or mental health services are welcome to participate without becoming a sponsor. Non-sponsoring agencies will be required to bring their own table and will only have their name listed in the Community Resource section of the program.
I want to participate without becoming a sponsor of Stop the Stigma
Here is how my Company will represent itself during the Stop the Stigma event:
We encourage all participating companies and agencies to bring freebies, information brochures, games, or activities to set-up at their table to interact with event attendees.
I want to have a table/booth at the event
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Yes
No
Terms of participation/sponsorship
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1. Participants and sponsors shall not sell or solicit any products, services, gifts, or other to any event attendees. Participants are allowed to provide education and information about services available.
2. All activities, games, and give-aways will be free for event attendees. No participant shall charge event attendees for any of these items during the event.
3. All handouts, displays, freebies, give-aways, games, activities, and educational materials shall be appropriate and shall not contain any content that discriminates on the basis of race, gender, ethnicity, or sexual identification.
4. Participation in this event is at your own risk. The Sarkis Family Charitable Foundation, Stop the Stigma committee, or any other agency present is free from any liability for any property damage or loss, injury, or illness sustained by participating in this event.
5. No refunds or rain checks shall be issued in the event of severe weather or other "acts of God."
6. The event committee reserves the right to dismiss any individual or agency in violation of these terms or for any other reason at any time during the event without refund.
I agree to these terms.