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NAME
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EMAIL ADDRESS

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PHONE NUMBER

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ORGANIZATION/ROLE (If Applicable)
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Please select your Participation Level?
Friends of HUG ME Ink ($25): Listing in the HEALTHY MINDS, HEALTHY HEARTS program only.
Wellness Resource ($75): 1 table, 2 chairs, 2 Conference Registrations (including lunch), and listing in HEALTHY MINDS, HEALTHY HEARTS program.
Advocates ($300): 1 table, 2 chairs, 2 Conference Registrations (including lunch), listed on HMHH website, and logo on event banner.
Peer Supporters ($500): Everything in Advocates Level PLUS 1/4 Page Ad displayed in the HEALTHY MINDS, HEALTHY HEARTS program.
Community Supporters ($1,000): Everything in Peer Supporters Level PLUS 1/2 Page Ad displayed in the HEALTHY MINDS, HEALTHY HEARTS program and logo with hyperlink on HMI website
Recovery Rock Stars ($2500): Everything in Advocates Level PLUS Full Page Ad displayed in the HEALTHY MINDS, HEALTHY HEARTS program and logo on Conference promotional item (T-shirt or Swag Bag).
None, I am purchasing an ad

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If purchasing an Ad, please select which size
All ads are in full color. We will contact you with obtain your ad in either a JPEG or PNG format.
Business Card Size $45
¼ Page Ad Size $75
½ Page Ad Size $150
Full Page Ad Size $300
I am not interested in placing an ad.

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I understand my registration is not complete until I have submitted payment. Once I submit this form, I will be sent an invoice to pay via credit card.
If you need to mail-in a check, please contact us for invoice with mailing address.
I accept.

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