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)