AMGA 2018 IQL Exhibitor Registration

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Please send only one registration for your entire organization.

AMGA 2018 Institute for Quality Leadership
Medicare Advantage and Risk: Delivering on the Promise of Value
November 13-15, 2018
Hyatt Regency
San Antonio, Texas
amga.org/IQL18

1. Fill out the form below and hit Submit.

2. Print out form and mail or fax to 703.548.1890

Fred Haag
AMGA
One Prince Street
Alexandria, VA 22314-3318

 

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Complimentary Registrations:

Names and email addresses of your on-site representative
(NOTE: Platinum Host receives 6 complimentary registrations and Gold Contributors receive 4 complimentary registrations. Additional registrations can be purchased for an additional fee.)

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Additional Representatives:
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Contribution Categories

Platinum Host @ $25000
Gold Contributor (Chairman's Circle) @ $6000
Gold Contributor (Premier Corporate Partner) @ $6750
Gold Contributor (Executive Corporate Partner) @ $7125
Gold Contributor (Non-member) @ $7500
AMGA Corporate Partner Additional Registrations (each) @ $825
Non-member Additional Representatives (each) @ $1195
App Sponsor @ $5000
AV Sponsor @ $15000
Wi-Fi Sponsor @ $10000
Registration Snack Cart @ $5000
Total Amount Enclosed

Payment in full is to be included with this contributor registration. Cancellations of exhibits received by September 7, 2018 will receive a refund (less a $500 processing fee). No refunds can be made after this date.

You may also fax the registration form to 703.548.1890 or mail with check to AMGA, Attn: Fred Haag, One Prince Street, Alexandria, VA 22314-3318. For further information or to pay with credit card, contact Fred Haag at 703.838.0033, ext. 329 or fhaag@amga.org.

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Your form submission WILL be encrypted using SSL to ensure your privacy.

AMGA | One Prince Street, Alexandria, VA 22314-3318
(703) 838-0033 phone (703) 548-1890 fax
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