Hospital Design Blueprint Program
Please complete the information in this form to submit your Hospital Design Blueprint Program insertion order.
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What is the company name/brand being promoted? *

 
Who is your Strategic Account Manager (SAM)? *


 
What is the name of the main point of contact for this ad submission? *

 
What is their phone number? *

Please provide the best number to reach them.
 
If this person is an agency representative, please specify the agency.

 
Please select from the choices below:

Sponsorship Option 1: Donate a Passport Prize | $300 
- We will be giving away daily prizes to Hospital Design attendees for submitting their Blueprint booklet
- Donate a prize for the Blueprint program, minimum value of $100, and send an attendee home with a brand reminder of your company, service or product! You could even donate a free consult! The NAVC must approve the prize.
- Ability for one team member to attend the Saturday night Hospital Design Reception
- 1 of 16 spots on the Blueprint booklet provided only to Hospital Design attendees  

Sponsorship Option 2: Participate Without a Prize Donation | $600
- Ability for one team member to attend the Saturday night Hospital Design Reception
- 1 of 16 spots on the Blueprint booklet provided only to Hospital Design attendees *


 
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Please specify a purchase order number if you'd like us to include it on the invoice.

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


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

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

 
TERMS & CONDITIONS 


Payment Terms

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

Cancellations
Sponsor may cancel the Sponsorship Agreement in writing; however, sponsor agrees to the following refund schedule:   
91 – 120 days before the first day of the program (Conference or Institute) – 90% Refund 
61 – 90 days before the first day of the program (Conference or Institute) – 75% Refund 
31 – 60 days before the first day of the program (Conference or Institute) – 50% Refund 
Less than 30 days or less before the first day of the program (Conference or Institute) – 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 Solutions@NAVC.com.