Case Management  Society of Eastern Oklahoma           
CMSA 2013-2014 Conference Sponsors

Meet our Platinum Sponsors at this time...
Openings for 3 additional Platinum Sponsors
available this year.
Will it be YOU???

Ambassador Manor & Rehabilitation
Grace Hospice
Hanger Clinic
Kindred LTAC
Senior Star
Senior Suites
The Villages at Southern Hills
Tulsa Nursing Center

Special thank-you to the above sponsors!!!
We look forward to a great partnership.
Sponsor Registration Form
I/My Organization would like to be a 2013-2014 Sponsor of CMSA of Eastern Oklahoma
Platinum  Conference Sponsor $3,000.00
Gold Conference Sponsor $2,000.00
Silver Conference Sponsor $1,500.00
Bronze Sponsor $1,000.00
Sponsor information:
Company Name:



Address Street 1:

Address Street 2:

City:

Zip Code:

(5 digits)
State:

Phone:

Fax:

E-Mail:





Complimentary conference Attendees: # of attendees are based on the sponsorship chosen--please see sponsorship criteria for details.
 Conference Attendee #1


Certificate #:
 Certificate # will be assigned by CMSA of Eastern Ok. All conference attendees must complete an attendee registration form.
Conference Attendee #2:


Certificate #::
Certificate # will be assigned by CMSA of Eastern Ok.  All conference attendees must complete an attendee registration form.
Conference Attendee #3:


Certificate #::
Certificate # will be assigned by CMSA of Eastern Ok.  All conference attendees must complete an attendee registration form.
Conference Attendee #4:


Certificate #::
Certificate # will be assigned by CMSA of Eastern Ok.  All conference attendees must complete an attendee registration form.
Conference Attendee #5:


Certificate #::
Certificate # will be assigned by CMSA of Eastern OK.  All conference attendees must complete an attendee registration form.
Conference Attendee #6:


Certificate #::
Certificate # will be assigned by CMSA of Eastern OK.  All conference attendees must complete an attendee registration form.
Conference Attendee #7:


Certificate #::
Certificate # will be assigned by CMSA of Eastern Ok.  All conference attendees must complete an attendee registration form.
Conference Attendee #8:


Certificate #::
Certificate # will be assigned by CMSA of Eastern Ok.  All conference attendees must complete an attendee registration form.
Conference Attendee #9:


Certificate #::
Certificate # will be assigned by CMSA of Eastern OK.  All conference attendees must complete an attendee registration form.
Conference Attendee #10:


Certificate #::
Certificate # will be assigned by CMSA of Eastern OK.  All conference attendees must complete an attendee registration form.
Payment Method:
Check #:



Credit Card:4% surcharge on all Credit Card payments


Master Card
Visa
Discover
Credit Card #:


Expiration Date::
Total Due


(USD)
Other Information
Comments:



I authorize CMSA of Eastern OKlahoma to charge my Credit Card if that is the payment option listed.
I understand a 4% surcharge will be added. to all Credit Card payments.



I understand my contact information as listed above will be included in the conference attendee packet information for networking purposes.

We the Undersigned do Hereby Agree to the Following:

a)      All provisions of the rules and regulations to be sent with the sponsorship acknowledgement letter are to be followed.

b)      See attachment for sponsorship level details. Furnishings, labor, shipping and hotel arrangement must be made individually.

c)      Checks should be made payable to the CMSA-Eastern OK.  Payment of sponsorship should be made by April 15, 2013 or recognition on signs  & related conference materials will not be guaranteed. Initial payment must be received by 2/21/2013 for split payments.

d)      Sponsorship levels are available on a first-come basis when your application and payment is received.  For Sponsorships that include booth space --factors may influence space assignment such as date of registration, special needs, and general layout of exhibits.

e)      It is agreed by signing this form you understand and will comply with all the guidelines stated above while at the Marriott Southern Hills.  Failure to comply with any of the above stated guidelines will result in a $250.00 damage fee, payable by the Exhibitor at the time of the event.


Thank you for submitting your registration via this website.
Registration is not complete until payment is received in full.

We look forward to your 2013-2014 partnership with CMSA of Eastern Ok. Conference.

Please use the contact information below for any questions???
 CMSA of Eastern Ok
PO Box 35766
Tulsa, OK.  74153

Phone: (918) 488-6165 or (918) 851-8710 for sponsorship information.

Fax: (918) 488-8021
Email: info@cmsa-easternok.org


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