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Sponsorships are available on a first-come, first-reserved basis by completing and submitting this Support Application. Upon receipt of the application and indication of payment method, an email will be sent confirming requested sponsorship item(s).

Sponsoring Organization & Contact Information

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Use upper and lower case letters exactly as you want your organization's name to appear in conference materials and signage.
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Please provide your organization's website URL for inclusion in promotional materials, if applicable.
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Company representative to receive all information regarding the sponsorship.
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Sponsorship Items & Payment Information

Select this option if you are not exhibiting or purchasing a sponsorship item.
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Check all that apply.

Make checks payable to OptumHealth Education
Federal Tax ID: 30-0238641
Mail to:
OptumHealth Education
Attn: Bethany Severson
MN101-W800
11000 Optum Circle
Eden Prairie, MN 55344
(A mail service that provides tracking information is recommended.)

You indicated payment by credit card. Preview your application and then click the submit button to complete the application process. Instructions to process your credit card payment will be provided on the next screen.

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Please enter your coupon code. If there is a balance due, also select the applicable form of payment (check or credit card). If paying by credit card, enter the code during checkout.

Acknowledgement

By applying for a sponsorship item(s), the applicant agrees to abide by all Terms and Conditions contained in the Supporter Prospectus.