Corporate Sponsorship Form

2020-2021 Half Year Corporate Sponsorship Program: Enrollment Form

Please enroll me as an HFMA Massachusetts-Rhode Island Chapter Half-Year Corporate Sponsor at the following level: *

Platinum Sponsorship Fee $3,125

Gold Sponsorship Fee $1,875

Silver Sponsorship Fee $1,250

Payment Options *

Check

Please bill me for the full amount

I will contact the office to arrange payment over the phone

If you indicated "Check" above, please indicate the amount enclosed.

Full Name *

Company *

Company Address *

City *

State *

Zip Code *

Sponsorship Contact (Full Name) *

Phone Number *

Email *

Corporate Profile & Ad Copy Contact (Full Name) *

Phone Number *

Email *

If you are human, leave this field blank.