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2020 WSHA Annual Convention
Champions of our ProfessionFebruary 27-29, 2020
The Ingleside Hotel, Waukesha, WI
REGISTRATION FORM
Sponsorship Registration
Contact Information (to receive confirmation)
Name:
Address:
Phone:
Email:
Company Information
Company Name:
Web Address:
Company Phone:
Companies to Avoid:
Sales RepresentativeList name (s) as you would like them to appear on name badges:
Rep 1:
Rep 2:
Special Assistance:
Exhibitors may purchase additional badges for $50 each.
Additional Registration Badges
Extra Badges x $50 =List name (s) for additional staff as you would like them to appearon name badges:
Name 1:
Name 2:
Sponsor Package
Platinum Sponsor - $3,500
Gold Sponsor - $2,500
Silver Sponsor - $1,500
Bronze Sponsor - $1,000
All sponsor levels include an exhibit display:
Exhibit Registration
$500 - WSHA Affiliate Member Exhibit Table
$750 - Non-Affiliate Mmeber Exhibit Table
$50 - Electricity
Method of Payment
WSHA's Tax ID number is 20-3149613.
Total Enclosed: $
Check (Payable to WSHA) check #:
Visa MasterCard Discover AMEX
Card Number:
Expiration Date: /Security Code:
Address on Billing Statement:
Name on Card:
Signature:
Please return registration form and payment to:
WSHA Office
563 Carter Court, Suite B, Kimberly, WI 54136
Fax: 920-882-3655, Email: WSHA@badgerbay.co (not .com)
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