Application to sponsor 2023

Contact details

First name *

Surname *

Position *

Organisation (marketing) *

Organisation (invoicing) *

ABN *

Postal address 1 *

Postal address 2

State/territory *

Country *

Postcode *

Phone

Mobile phone *

Email *

Website *

Sponsorship items

Please select one:

Sponsorship *

Platinum sponsor $16,500

Gold sponsor $11,000

Silver sponsor $5,500

Bronze sponsor $2,750

Coffee cart sponsor (Tuesday to Thursday) $5,500

Coffee cart sponsor (Tuesday to Friday) $6,500

Coffee cart sponsor (Friday only) $1,500

Other details

Public liability insurance

(required by all exhibitors)

Name of insurer

Date insurance falls due

Day

Month

Year

Insured amount

Declaration and payment

Terms and conditions *

I accept the points listed in the declaration, agree to be invoiced for the total amount payable, and am authorised to make the commitment of behalf of my organisation. I understand and accept the inclusions of the sponsorship package I am purchasing, and have read, understood and agree to the terms and conditions of sponsorship in the PAH Health Symposium 2023 sponsorship prospectus.

Total amount payable *

Name *

Date *

Day

Month

Year

Leave this field blank

Last updated 17 March 2023

Last reviewed 17 March 2023

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