Souvenir Program Sponsorship Form

If you are interested in sponsoring an ad for the First Biennial Meeting & Reunion on June 25, 2016 in Las Vegas, Nevada, please fill out the following sponsorship form.

Souvenir Program Sponsorship Form

Name (Last, First, MI)(required)

Street Address(required)

City(required)

State/Province(required)

Zip Code(required)

Country(required)

Email (Your receipt will be emailed to you.)(required)

By checking this box, I certify that the above information is correct and represents my pledge of support for the publication of the USAPMTIAA First Biennial Meeting & Reunion souvenir program.(required)

Paying by Credit Card

If paying by credit card, please follow the link to PayPal.

Paying by Check

If paying by check, please write a check in the amount of indicated above payable to USAPMTIAA. Please mail the check to:

Ednie A Mckeehan
USAPMTIAA Treasurer
7645 W Arndt Ct
Laporte, IN 46350
USA

Incentives for Sponsor

Souvenir Ad Incentives

Please email your camera-ready advertisement or greetings to mtorrentomd@gmail.com.

Thank you for your interest in supporting our First Biennial Meeting & Reunion souvenir program.

USAPMTIAA is a 501(c)3 organization. Any donation you send to USAPMTIAA is tax-deductible.

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