Sponsorship Registration | Tennessee Self-Insurers Association

Choose Sponsorship Level*

Includes Sponsorship of Conference Reception and Signage Recognition
Includes Conference Registration for up to 4 individuals- $1200 value
Includes Exhibitor Booth at Reception & Conference (Premium Location)- $1,500 value
Includes Individual Logo Exposure in Presentation & Handouts
Includes TNSIA Membership dues paid in full for Calendar Year 2019- $750 value

Includes Sponsorship of Breakfast and Signage Recognition
Includes Conference Registration for 2 individuals
Includes Exhibitor Booth at Reception & Conference (Premium Location)- $1,500 value
Includes Individual Logo Exposure in Presentation & Handouts
Includes TNSIA Membership dues paid in full for Calendar Year 2019- $750 value

Business Name*

Contact Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Note: It is important that the Company Address matches the billing address for card being used.

Address*

Street Address Address Line 2 City State ZIP Code

Attendee Name 1*

First Last

Email 1*

Attendee Name 2

First Last

Email 2

Attendee Name 3

First Last

Email 3

Attendee Name 4

First Last

Email 4

Payment Type*

To pay by credit card, select Paypal as your option. Please note that PayPal fees will not be refunded to the web page.

Reception RSVP*

Do you plan to attend the Welcome Reception on Thursday, September 6th at 4:30 PM CST?

Reception Attendee Name 1

First Last

Reception Attendee Name 2

First Last

Reception Attendee Name 3

First Last

Reception Attendee Name 4

First Last

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