Digital Media Insertion Order
Please complete the information in this form to submit your digital media insertion order form.
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What is the company name being promoted? *

Who is your Strategic Account Manager (SAM)? *

If you are an agency representative, please specify the agency name.

What is your name? *

Please select all the digital media you'd like to secure. *

Please select the website banner type you'd like to secure. *

What date would you like the eblast to go out? *

*PLEASE NOTE: Artwork is dues 10 days prior to email distribution date.
Your invoice total will be $ {{var_score}}.

Invoices can be paid by check or by credit card.
Please specify a purchase order number if you'd like us to include it on the invoice.

Would you like to receive an invoice by mail or by email? *

What address would you like us send the invoice to? *

Please include the full company name & mailing address.
Do you have any special requests or instructions?



The NAVC reserves the right to approve all of the contents of advertisement as well as the option to reject or cancel any advertisement, IO, URL link, space reservation or position commitment, at any time, for any reason whatsoever, even if the advertising has been published previously by the NAVC. If your artwork includes a logo or text reference to the NAVC, the NAVC Conference, or the NAVC Institute it must follow our brand standards

Artwork Submission
All artwork must be received by the following dates:
• Banner Ads - 14 days prior to start date
• Connect2Care Newsletter Ads - 7 days prior to delivery date
• Customized eBlast - 14 days prior to delivery date

Artwork Specs
Please review the Partner Power Guide for full artwork specs.

Payment Terms

Advertising payment will be due and payable upon receipt of invoice but no later than 30 days from date of invoice.

Sponsor may cancel the Advertising Agreement in writing; however, sponsor agrees to the following refund schedule:  
91 – 120 days before reserved advertising artwork due date (as outlined on form) – 90% Refund
46 – 90 days before reserved advertising artwork due date (as outlined on form) – 75% Refund
45 days or less before reserved advertising artwork due date (as outlined on form) – No Refund *

I have read and understand the terms, of this agreement, and have the authority to execute same, and in doing so accept full responsibility for payment of advertising under the terms of this contract. 

I understand that selecting the button "I accept" constitutes a legal signature confirming that I acknowledge and agree to the above Terms & Conditions.
Thank you for completing this form. 

If you have any specific questions or issues, please contact your SAM directly, or email us at