SPONSOR & EXHIBITOR APPLICATION & AGREEMENT
Sheraton Memphis Downtown, TN October 15-17, 2015
Begun by the North Carolina Community Health Center Association in 1988, the East Coast Migrant Stream Forum is an annual conference that offers health professionals skills-based trainings and professional development opportunities in the migrant health field. The audience includes outreach workers, front-line staff, healthcare providers, administrators, and other health advocates.
Through workshops and networking opportunities, attendees are exposed to the latest in workforce development skills training, clinical trends, farmworker-specific service delivery models, cutting-edge research, and legislative and funding initiatives.
All payments and artwork must be received by September 16, 2015
Platinum Sponsorship Packages $5,500 | 3 Opportunities Available
Welcome Reception—Thursday Evening, October 15, 2015
This opening reception sets the stage for the entire conference! All conference participants are invited to mingle, network and have fun while enjoying tasty hors d’oeuvres. As a sponsor you will be given the opportunity to address the entire body and highlight your product.
Keynote Speaker—Friday, October 16, 2015
Help bring a nationally prominent speaker to the East Coast Migrant Stream Forum! Your support of this year’s Keynote Speaker will help cover travel and/or speaker fees. The Keynote Speaker addresses conference attendees at the most highly attended session of the conference. With this option, you can address all participants at the start of the Opening Plenary during lunch.
Conference Padfolio or Conference Bag Sponsorship
Leave an impression on conference participants long after the conference ends! The complementary, high-quality promotional item is designed for long-term use and made available to all attendees at the onsite conference registration desk. Choose this sponsorship option and we’ll place your company’s logo on the outside of the padfolio/bag all participants receive. All artwork must be received by
September 16, 2015.
Platinum Sponsors receive:
 Full-page ad in the conference program.
 Company name displayed during sponsored event
 Advanced digital copy of conference participant list
 One 6-foot skirted table with chairs
 Two exhibitor registrations
Gold Sponsorship Packages $3,500 | 5 Opportunities Available
Breakfast—Friday, October 16, 2015 or Saturday, October 17, 2015
Two full-service breakfasts will be provided to conference attendees. Promote your company and help start participants’ day off right by supporting these well-attended events. We will be happy to recognize your support at this event.
Lunch—Friday, October 16, 2015 or Saturday, October 17, 2015
Two full-service lunches will be provided to conference participants. These events always have a great turnout and provide an excellent opportunity for companies to network and engage the attention of participants. We will be happy to recognize your support at these events.
Farm Tour—Thursday, October 15, 2015
Unique to the East Coast Migrant Stream Forum is a tour of a local agricultural operation or clinic serving special populations. This tour is always a conference highlight.
Gold Sponsors receive:
 Half-page ad in the conference program
 Company name displayed during sponsored event
 Advanced digital copy of conference participant list
 One 6-foot skirted table with chairs
 One exhibitor registration
North Carolina Community Health Center Association
East Coast Migrant Stream Forum
Page 1 of 4
4917 Waters Edge Dr., Suite 165
Raleigh NC 27606
Steve Smith, smiths@ncchca.org
or (919) 297-0016

SPONSOR & EXHIBITOR APPLICATION & AGREEMENT
Sheraton Memphis Downtown, TN October 15-17, 2015
Silver Sponsorship Packages $2,500 | 3 Opportunities Available
Full Snack Refreshment Breaks—Friday Morning, October 16, 2015 or Friday Afternoon, October 16, 2015
These snack breaks provide an opportunity for attendees to reenergize. Light refreshments, soda, and tea will be available. You’ll be able to network with participants as they relax during their break. Your agency’s name will be displayed at the snack table.
Nametag Lanyard
Conference attendees will receive a durable lanyard displaying their nametag throughout the length of the entire conference. Choose this option and we’ll print your company’s name or logo on all of conference lanyards. Be seen at all times!
Silver Sponsors receive:
 Company name in conference program
 Plenary acknowledgement
 Advanced digital copy of conference participant list
 One 6-foot skirted table with chairs
 One exhibitor registration
Non-Profit Exhibitors $500
Exhibitors receive:
 Organization name listed in conference program
 Plenary acknowledgement
 Advanced digital copy of conference participant list
 One 6-foot skirted table with chairs
 One exhibitor registration
Donor
Your donation of any level will help support conference attendance for farmworker promotores(as).
 Donors who provide a minimum of $500 will receive a half-page ad in the conference program.
All payments and artwork must be received by September 16, 2015.
Registration
To register fill out the form below, and return by email or U.S. mail with payment by check or credit card.
Deadlines
All payments and artwork must be received by September 16, 2015 for inclusion in conference materials. Send high resolution artwork to Steve Smith at
Hotel Information
Sheraton Memphis Downtown
250 North Main Street
Memphis, Tennessee 38103
(901) 527-7300
Reserve a Room smiths@ncchca.org
Hotel rate per night: $134. Mention the East Coast Migrant Stream Forum for discounted hotel rate.
.
Exhibitor Schedule
Thursday, October 15, 2015
Exhibitor Set-up
12:00 pm – 1:00 pm
Exhibit Hall Open
1:00 pm – 5:00 pm
Friday, October 16, 2015
Exhibit Hall Open
8:00 am – 5:00 pm
Saturday, October 17, 2015
Exhibit Hall Open
8:00 am – 12:15 pm
Setup
Exhibits may be set up between 12:00 pm – 1:00 pm on Thursday, October 15, 2015. Exhibitors are encouraged to enjoy all meals and network with conference attendees at every opportunity. Please check in at the 2015 East Coast Migrant Stream Forum Registration
Desk upon arrival where you’ll receive all conference materials including badge, program, and participant list.
Questions?
Contact Steve Smith, Business Development Manager, at smiths@ncchca.org
or
(919) 297-0016 for more information on sponsorship opportunities.
North Carolina Community Health Center Association
East Coast Migrant Stream Forum
Page 2 of 4
4917 Waters Edge Dr., Suite 165
Raleigh NC 27606
Steve Smith, smiths@ncchca.org
or (919) 297-0016

SPONSOR & EXHIBITOR APPLICATION & AGREEMENT
Sheraton Memphis Downtown, TN October 15-17, 2015
Contact Information
Please TYPE all information as you’d like it to appear on printed materials.
Organization/Complete Agency Name:
Address:
City: State:
Main Contact: (To receive correspondence):
Title:
Phone:
Email:
Fax:
Organization Website:
Zip:
Attendees
Representative to receive complimentary registration--based on sponsorship level:
Name Title: Email:
Platinum Sponsors Only Second Representative to receive complimentary registration
Name: Title: Email:
Additional Representatives Attending at rate of $200.00/person:
Name:
Name:
Name:
Title:
Title:
Title:
Email:
Email:
Email:
NCCHCA may document the conference for promotional purposes. Your participation may be filmed or photographed at this event.
Registration is consent for use of these images and recordings by NCCHCA.
Facilities
Need an electrical outlet? Yes No (Not guaranteed, but we’ll do our best to accommodate your request.)
Select Your Package Options
PLATINUM SPONSORSHIP $5,500 Welcome Reception
GOLD SPONSORSHIP $3,500 Friday Breakfast
Keynote Speaker
Saturday Breakfast
Conference Padfolio or Conference Bag
Friday Lunch
Saturday Lunch
SILVER SPONSORSHIP $2,500
Closing Speaker
Friday Morning Full Snack Refreshment Break Saturday Morning Full Snack Refreshment
Break
Nametag Lanyard
NON-PROFIT EXHIBITOR $500
DONATION: Enter amount $
ADDITIONAL EXHIBIT REPRESENTATIVES $200/PERSON Indicate quantity
Method of Payment
Payment must accompany agreement to confirm attendance. Agreement, payment and art work must be received by September 16,
2015. NO REFUNDS.
Make checks payable to: North Carolina Community Health Center Association
Please charge my: MasterCard Visa Discover AM/EX
Expiration Date: Card Security Code: What’s this?
Credit Card Number:
Name as it appears on credit card:
Billing address:
Billing phone number:
Total Enclosed: $
Signature (required): ___________________________________________________ Date:
Return completed form with payment by September 16, 2015:
North Carolina Community Health Center Association
FINANCE DEPARTMENT
4917 Waters Edge Drive, Suite 165
Raleigh, NC 27606
Fax (919) 469-1263
The North Carolina Community Health Center Association
(NCCHCA) wishes to thank all of our sponsors, exhibitors, and speakers for their support. NCCHCA does not endorse specific vendor products or services or any speaker views or opinions shared. NCCHCA is not responsible for content expressed and cannot be held liable for information received.
North Carolina Community Health Center Association
East Coast Migrant Stream Forum
Page 3 of 4
4917 Waters Edge Dr., Suite 165
Raleigh NC 27606
Steve Smith, smiths@ncchca.org
or (919) 297-0016

SPONSOR & EXHIBITOR APPLICATION & AGREEMENT
Sheraton Memphis Downtown, TN October 15-17, 2015
PLEASE TELL US MORE ABOUT YOURSELF: (Required)
Our primary funder has requested that we obtain the following information for all conference attendees.
How many years have you worked in Farmworker Health?
Less than 1 year 1 to 3 years 4 to 6 years 7 to 10 years
How many times have you attended the East Coast Migrant Stream Forum? (Required)
First-time attendee Two Three or more
11 years or more
Which category best describes your primary occupation? (Required – Check One)
Administrator
Advocacy/Policy
Farmworker
Health/Primary Care Provider
State Primary Care Association Staff
Researcher
Behavioral Health Provider
Clinical Support Staff
Dental Professional
Executive Director/CEO
Lay Health Worker/Promotor(a)
M/CHC Board Member
Outreach Worker/Coordinator
Practice/Office Manager
State/Federal Employee
Student
Other – Please specify:
North Carolina Community Health Center Association
East Coast Migrant Stream Forum
Page 4 of 4
4917 Waters Edge Dr., Suite 165
Raleigh NC 27606
Steve Smith, smiths@ncchca.org
or (919) 297-0016