CPA Virtual Conference Sponsor Form - Canadian Psychiatric Association - Association des psychiatres du Canada

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CPA Virtual Conference Sponsor Form

Home CPA Virtual Conference – Oct. 23-24, 2020 CPA Virtual Conference Sponsor Form

Step 1 of 4

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Name of Company*
Listing you wish to appear in virtual platform
Name of Contact*
First Last
Email Address*
Check Yes if billing contact name and email address are different from above.
- Yes
Name of Billing Contact
First Last
If different from contact name
Billing Contact Email Address

If different from contact email address
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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PO Number or Billing Reference Number
Company Profile*
- Publisher
- Recruiter
- Pharmaceutical
Publisher Sponsor Packages*
- Bronze - $250 CAD - No Complimentary Registrations
- Silver - $300 CAD - Includes 1 Complimentary Registration
- Gold - $500 CAD - Includes 2 Complimentary Registrations
Recruiter Sponsor Packages*
- Bronze - $2,000 CAD - No Complimentary Registrations
- Silver - $2,500 CAD - Includes 2 Complimentary Registrations
- Gold - $3,000 CAD - Includes 3 Complimentary Registrations
Pharmaceutical Sponsor Packages*
- Bronze - $5,000 CAD - No Complimentary Registrations
- Silver - $7,500 CAD - Includes 3 Complimentary Registrations
- Gold - $10,000 CAD - Includes 4 Complimentary Registrations

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All complimentary registration names MUST be submitted before NOON October 16th, 2020, via this form or sent to conference@cpa-apc.org
Complimentary Registration Name # 1
First Last
Email Address # 1
Complimentary Registration Name # 2
First Last
Email Address # 2
Complimentary Registration Name # 3
First Last
Email Address # 3
Complimentary Registration Name # 4
First Last
Email Address # 4

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Confirmation*
On behalf of the organization listed above, I hereby confirm our participation as a sponsor of the CPA’s Virtual Annual Conference. I understand that the balance of the sponsorship will be invoiced upon CPA’s official acceptance of this application.

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