Energy InSites Symposium – Sponsorship Registration

Sponsorship Registration
Organization and Primary Contact
Name of Organization
Primary Contact Name

First NameLast Name
Position/Title
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Billing and Invoice Information
Billing Contact Name
Billing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Invoice Email
example@example.com
Purchase Order Number (if applicable)
Sponsor Recognition and Logo Upload
Requested Sponsorship Level
Custom sponsorship arrangements are subject to organizer review and confirmation.
Proposed Custom Sponsorship Amount (CAD)
Enter the dollar amount in CAD.
Please describe any recognition, participation, or partnership ideas you would like us to consider.
Upload Organization Logo

Cancelof
Complimentary Attendee Information and Needs
Complimentary Attendee Information
Complimentary Attendee Needs
Authorization and Agreement
Authorized Applicant Name
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Contact Information
Should be Empty:

Sponsorship Registration