KnowledgeConnex

All questions marked by an asterisk are required

Event Name:

Montana HIMA | 2022 Corporate Sponsorship

*Sponsorship Level:

Sponsorship ($500)

*Company:

*Address:

*City:

*State:

*Zip/Postal Code:

Please provide a marketing/sales description about your company's products or services

Company Description:

Website:

Company Logo:

Contact 1 Information

*First Name:

*Last Name:

*Phone Number:

{xxx-xxx-xxxx}

*Email Address:

*Retype Email Address:

Contact 2 Information

Contact Name 2:

Contact 2 Email:

Phone :

*Method of Payment:

Pay by Check
Credit Card

I have reviewed and acknowledge acceptance of the terms and conditions which includes the insufficient check funds policy and credit card terms and conditions.

Save Information:

{Checking this option will save your information for future registrations}