Ticket & Sponsor Commitment Form

Organization Name*

Contact Name*

E-mailadres*

Telefoon

Please provide name and email address of attendee to be registered for the event.

Please provide name and email address of attendees to be registered for the event.

E-mail

Use this link to pay via credit card. https://districtofcolumb.securepayments.cardpointe.com/pay?

By submitting the form you are authorizing the DC Hospital Association to invoice you for the sponsorship above. Payment must be received before sponsorship benefits begin. For individual and table tickets, invoices must be paid by August 1.

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