University Conference Publisher Sponsorship Form

Publisher/Company Name*

Contact Person Full Name*

First NameLast Name

Contact Email Address*

example@example.com

Contact Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Company Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Publisher Website

Brief Description of Your Publishing Activities*

Logo placement on conference websiteBooth at conference venueInclusion in conference program bookletSponsored session or workshopDistribution of promotional materialsOther (please specify)

Bank TransferCheckOther (please specify)

Upload your company logo or promotional material (optional)

Signature of Authorized Representative*