INDIANA ENVIRONMENTAL HEALTH ASSOCIATION
2016 Fall Educational Conference Sponsorship Form

Blue Chip Stardust Event Center

777 Blue Chip Drive

Michigan City, IN 46360

September 26-28, 2016

Please Print:Please Respond by: August 1, 2016

Organization/Sponsor:

Address:

(address)(city)(State) (zipcode)

Contact Person: Telephone No.:

Conference Attendees (if included in sponsorship level):

Email Address: ______

Your Support is Sincerely Appreciated!!!!!

Sponsorship / Cost / Includes:
Key Card
/ $3,000 / FIRST TIME EVER! Blue Chip has agreed to custom print all attendee room keys with this sponsor’s information. The Key Cards are to be retained by each attendee and should NOT be returned at check-out. This sponsorship will also include: 2 full-conference registrations (including meals & entertainment); 1 complimentary room (Sunday-Tuesday) in the Spa Tower at Blue Chip; exhibitor space; a 1-year IEHA Sustaining Membership; IEHA Award; and exhibitor introduction.
Platinum / $2,500 / This sponsorship includes: 2 full-conference registrations (including meals & entertainment); 1 complimentary room (Sunday-Tuesday) in the Spa Tower at Blue Chip; 1 full-page color ad in the program (front or back cover); 1 choice exhibitor space; 2 power point advertisement slides and up to 5 product information slides to be shown at the Awards Banquet and in the main session room during breaks; a 1-year IEHA Sustaining Membership; a prominent acknowledgement in the post-conference issue of the Journal of Environmental Health (an IEHA periodical); an IEHA Award, and exhibitor introduction.
Gold / $2,000 / This sponsorship includes: 1 full-conference registration (including meals & entertainment); 1 complimentary room (Sunday-Tuesday) in the Blue Chip Tower at Blue Chip; 1 full-page color ad in the conference program (available page location); 1 exhibitor space; 2 power point slides to be shown at the Awards Banquet and in the main session room during breaks; a 1-year IEHA Sustaining membership; an acknowledgement in the post-conference issue of the Journal of Environmental Health (an IEHA periodical); an IEHA Award; and exhibitor introduction.
Silver / $1,000 / This sponsorship includes: 1 full-conference registration (including meals & entertainment); 1 exhibitor space; 1 full-page black/white ad in the conference program (available page location); 1 power point slide to be shown at the Awards Banquet and in the main session room during breaks; a 1-year IEHA Sustaining membership; and exhibitor introduction.
Bronze / $500 / This sponsorship includes: exhibitor space; exhibitor introduction; listing in the conference program highlighting break sponsorship. (A sponsorship at this level will allow the sponsor to add-on full conference registration, which includes all meals & entertainment at the IEHA member rate).
Friends of
IEHA / $100-$499 / This sponsorship includes: the sponsor’s name on the break table; a listing in the conference program highlighting the break.

Make Payment Payable:2016 IEHA Fall Educational Conference

Mail Payment and Form to: Indiana Environmental Health Association, Inc.

(Fax forms to Tami BarrettP.O. Box 457

(317-233-7387)Indianapolis, IN 46206-0457 Total Amount Remitted: $______

Questions: Call IEHA Executive Secretary Tami Barrett at 317-797-3255; e-mail OR

Patty Nocek at 219-608-9574; e-mail at

Slides(if included in sponsorship level) may be emailed to Margaret Voyles at

Note: All Sponsorships are tax deductible. Upon request, sponsors will receive a letter for tax filing purposes.