2024 Event Sponsorship Form

If you need to pay from an invoice, please click here to generate a downloadable invoice.

For questions regarding sponsorships or payment options, please contact Stacy Springgate at Stacy.Springgate@NursesOfAchievement.com. For problems or questions regarding the Web form below, please contact webmaster@NursesOfAchievement.com.

items marked with a * are required, and the form cannot be submitted if any of these values are missing!

Contact Information
We ask for your name and contact information in case we have questions about your sponsorship and to process your payment. This information is not sold or shared outside the Foundation that administers the Nurses of Achievement, and it is securely encrypted before being stored.
* first name:
* last name:
title:
company or
organization name:
* mailing address:
* city:
* state:     * ZIP:  
* phone
(nnn-nnn-nnnn):
      fax:  
* e-mail:
 
Contribution Level
* contribution option:
PLATINUM – $2,500
  • full-page ad in digital event program
  • 4 dinner tickets
  • either honor a nurse at the event or sponsor a nomination category
  • logo displayed at the event
  • verbal recognition from event host
DISTINGUISHED – $1,500
  • half-page ad in digital event program
  • 2 dinner tickets
  • honor a nurse at the event
  • logo displayed at the event
  • verbal recognition from event host
CONTRIBUTING – $1,000
  • quarter-page ad in digital event program
  • sponsor a nomination category
  • logo displayed at the event
  • verbal recognition from event host
SUPPORTING – $500
  • text recognition in digital event program
  • verbal recognition from event host
OTHER AMOUNT
  • verbal recognition from event host
 
Special Instructions
* attribution for donation:
myself
my company/organization
"in memory of"
"in recognition of"
anonymous donation
 
Payment
payment due:
* payment method:
credit card payment       send check
 
Process Order
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