Online Registration Form

Exhibitor/Sponsor - LPMA/MPA 2021 Virtual Spring Meeting

Please enter your information on the form below to Register and Pay for the Exhibitor/Sponsor - LPMA/MPA 2021 Virtual Spring Meeting.

First Name*

Last Name*

Company Name*

Address*

City*

State*

Zip*

Contact Email*

Contact Phone*

Please list the names and email address(es) of the representatives who will exhibit:

EXHIBIT ONLY

$1000
Virtual table/2-minute recorded video presentation/live chat with participants during Friday Reception and Saturday during designated Exhibit Time & Breaks

Resource Directory E-binder:

$500
(provided to each attendee)
Full page in event program with company logo/contacts/photos/phone numbers/Email Addresses

Banner Ad

$500
Approx. 1.5” x 2.5” company logo ad listed on landing pages within the virtual platform (separate from CME)

Total Amount

Payment method

Credit/Debit Card

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Type*

Card Holder Name*

Verification code*