Sponsor Form - North Carolina HIMSS

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Submit Date

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Old Sponsor Level(Required)

Annual Sponsor

Conference Sponsor

Regional Event Sponsor

Become a HIMSS North Carolina Chapter Sponsor and showcase your products and services to providers throughout the state of North Carolina. NC HIMSS works to shape the healthcare industry through encouraging the use of technology and promoting public policies that will improve healthcare delivery. Please complete the form below to sign up.

Sponsor Types(Required)

Annual Sponsor

Conference Sponsor

Regional Event Sponsor

Select one or more.

Annual Sponsor Opportunities(Required)

Premier - $6,750

Corporate - $4,500

Partner - $2,750

Conference Sponsor Opportunities(Required)

Special Event - $8,500

Name Badge - $5,000

Reception - $4,000

Bag - $3,500

Track - $1,500

Wi-Fi - $1,500

Regional Sponsor Opportunities(Required)

Exclusive In-Person Event - $4,000

Co-Sponsor In-Person Event - $2,000

Exclusive Virtual Event - $1,500

Exclusive National HIMSS Reception - $6,000

Co-Sponsor National HIMSS Reception - $3,000

Company Details

Company Name(Required)

Company Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Company Contact Name(Required)

Company representative we should contact regarding this sponsorship.

Company Contact Phone(Required)

Phone number for correspondence related to sponsorship.

Company Contact eMail(Required)

Email address for correspondence related to sponsorship.

Company Logo

Max. file size: 8 MB.

Hi Resolution image (EPS, AI, or other) to create your logo image for the site and other collateral material.

Annual Conference Sponsor Promotion Details

Marketing Contact Name(Required)

Contact name to post on your sponsor page.

Marketing Contact Phone(Required)

Phone number to post on the site.

Marketing Contact eMail Address(Required)

Email address used (not posted) to forward leads from your sponsor page.

Website Address - to be posted on our site

Website address (URL) to link to your company from your sponsor page.

Company Description - to be posted on our site

Company details to be posted on your sponsor page.

Services provided by Company(Required)

Other Product / Services Description

Payment Details

Method of Payment(Required)

Once you select 'Submit', you will be sent an email with details on where to send your check.

Total Due

If you have trouble with the online form, you can use the PDF version by clicking HERE.