Registration Services provided by
Sponsor Registration Step 1: Company and Contact Information
Merchant Services
September 26-27, 2018 Online Conference Registration
Sponsorship Opportunity You are invited to register as a sponsor for the Oregon Workers’ Compensation Educational Conference. The following sponsorship levels are available: Silver: $500 Contribution • Organization name will appear on a large “Thank You Sponsor” sign in exhibit area. Gold: $1,000 Contribution • One Complimentary attendee registration  Organization name and contact information will appear in conference program. • Organization name will appear on a large “Thank You Sponsor” sign in exhibit area.
Required Fields*
Company Name*
Specialty*  
Address*
Address Line 2*
City*
State*
Zip*
Phone*
Ext.

Fax

Company Contact Name:*

FirstLast

Contact Email*

Sponsor Package*
Purchasing Silver Sponsor Sponsor - $500

Purchasing Gold Sponsor Sponsor - $1000

Fill out Attendee Info only if you are purchasing a Gold Sponsor.
GOLD Sponsor Attendee Name**

FirstLast

Attendee Title**
Attendee Contact Email**