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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?
Exhibitor ($150)
Friends of HUG ME Ink ($500)
Advocates ($1,000)
Peer Supporters $2,500)
Community Supporters ($5,000)
Recovery Rock Stars ($7,500)
Community Champion ($10,000)
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 $40
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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