CONTACT INFORMATION

Contact First Name: *

Contact Last Name: *

Contact Phone: *

Contact Email: *

ONSITE ATTENDEES

Attendee 1 First Name:

Attendee 1 Last Name:

Attendee 1 Email:

Attendee 2 First Name:

Attendee 2 Last Name:

Attendee 2 Email:

SILVER SPONSORS (UP TO 3 ATTENDEES)

Attendee 3 First Name:

Attendee 3 Last Name:

Attendee 3 Email:

GOLD SPONSORS (UP TO 4 ATTENDEES)

Attendee 4 First Name:

Attendee 4 Last Name:

Attendee 4 Email:

PLATINUM SPONSORS (UP TO 5 ATTENDEES)

Attendee 5 First Name:

Attendee 5 Last Name:

Attendee 5 Email:

AGREEMENT

Today's Date: *

Sponsorship Package *

Platinum - $20,000 (spring & fall '24 meetings)

Gold - $10,000 (spring & fall '24 meetings)

Silver - $7,000 (spring & fall '24 meetings)

Bronze - $4,000 (spring & fall '24 meetings)

A la Carte Sponsorship Opportunities

WDS Scholarship Program Sponsorship (2024 - 1 Year) .....$5,000

WDS Scholarship Program Sponsorship (2024-25 - 2 Years) .....$10,000

Meeting Attendee Tote Bags (spring '24) .....$1,500

Meeting Attendee Lanyards (spring '24) .....$1,500

Meeting Attendee Hand Sanitizer Bottles (spring '24) .....$1,000

Meeting Attendee Meal: Breakfast (spring '24) .....$1,500

Meeting Attendee Meal: Lunch (spring '24) .....$3,000

Meeting Attendee Meal: Coffee Break (spring '24) .....$1,000

Meeting Attendee Charging Station (spring '24) .....$750

I will provide payment via check made out to the Wisconsin Dermatological Society (or "WDS") and send to 6737 W Washington St, Ste 4210, Milwaukee, WI 53214 by April 1, 2024. *

I Agree

Signature (Signer agrees to accept all terms described above.) *

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Wisconsin Dermatological Society

6737 W Washington St, Ste 4210 | Milwaukee, WI 53214