Sponsorship Request Form – Vermont Suicide Prevention Symposium

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Sponsorship Request Form

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Company or Group Requesting Sponsorship *

Name *

First

Last

Email *

Phone

Preferred Contact Method

Email
Phone
No preference

Please describe the event or program that the sponsorship will support.

Please indicate which sponsorship levels you are seeking. *

HEALTHY FOUNDATION SPONSOR • $10,000
HEALTHY CATALYST SPONSOR • $5,000
HEALTHY OUTCOME SPONSOR • $3,000
HEALTHY PRACTICE SPONSOR • $1,000
SPONSOR A WORKSHOP OR PANEL • $1,000
FRIEND OF VT SPC SPONSOR • $500
CONFERENCE EXHIBITOR SPONSOR • $250
EXHIBIT AT THE SYMPOSIUM • $150
SPONSOR A SCHOLARSHIP • $250–$1,000
SPONSOR A KEYNOTE • $2,500
SPONSOR A WORKSHOP OR PANEL • $1,000
MODERATE A WORKSHOP • $1,000
FEATURED BLOG POST • $500
EXHIBIT AT THE SYMPOSIUM • $150

Additional Comments / Requests

Name

of completed

Form completed

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