Registration: 2019 Heartland Foot and Ankle Conference - Sponsor and Exhibitor

Thank you for your interest in partnering with IPMS as an event sponsor for our Heartland Foot & Ankle Conference!   If you have any questions regarding your registration, please contact the IPMS office at 515-282-8192 or andrew@ipms.org.

Please note, you must review the rules and regulations for participation in this event.

 

USER INFORMATION
First Name:
Last Name:
Company:
Work Address:
Work Address 2:
Work City:
Work State:
Work Zip:
Primary Email:
Confirm Email:
Work Phone:
Fax:
Website:
Terms and Conditions:
I/We acknowledge and agree to comply with the conditions, rules, and regulations of the Heartland Foot and Ankle Conference.  
Onsite Contact (if different from above):
Onsite Contact Cell Phone:
Onsite Contact Email:
Onsite Contact City, State:
Please list names and cities of additional representatives:
Specific Products or services to be exhibited (check all that apply):
Ambulatory Devices
Billing: Software or Services
Business Services
Chairs and other Podiatric Equipment
Compounding Pharmacy/Lab
Computer Software
Implants & Surgical Devices
Instruments
Laboratory & Diagnostic Services
Medical Supplies
Office Supplies
Orthotics & Corrective Devices
Pharmaceuticals
School & Associations
Shoes
Skin Care Treatment/Therapy Modalities
Wound Care
Other
If your product doesn't fit into one of the above categories, please provide a category here:
Please list any competitors you do not wish to be placed next to (not guaranteed):
Please upload a copy of your logo here:
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Exhibitor Level:
Additional Sponsor Opportunities:
Lunch ($5,000)
Reception ($2,000)
Break ($1,000)
Lanyard and Badge ($2,000)
Conference Bag
Hotel Key Card ($2,000)
Mobile App ($1,500)
By submitting this online form, I understand and agree that IPMS will have my contact details for the purpose of processing my information and ensuring full participation. For complete privacy policy, click here.
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