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Exhibitor & Sponsor Registration
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2025 Capital Health’s Annual Continuing Education Conference:
Inspiring Minds, Advancing Medicine Together
March 14-15, 2025
Borgata Hotel & Casino
1 Borgata Way
Atlantic City, NJ 08401
Please complete the form below to register your company as a sponsor or exhibitor.
To pay via credit card, fill out the credit card fields and click Pay Now
To pay via check, leave the credit card fields empty, click Pay by Check, and an invoice will be emailed to you
*
indicates required field
Company Name
Name
First Name
Last Name
Address
Address
Address 2
City/Town
State/Province
- Select -
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces (Canada, Europe, Africa, or Middle East
Armed Forces Americas
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federate States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP/Postal Code
Phone Number
Email Address
Please verify the above information is correct
- Select -
I confirm the above information is correct.
Select your level
- Select -
Presenting - $50,000
Reception - $40,000
Hospitality - $30,000
Coffee/Snack - $25,000
Platinum - $17,000
Gold - $12,000
Silver - $8,000
Bronze - $5,000
Please provide the names of your attendees as it should appear on their name badge
Product Description
Please include a brief summary and description of your product or services.
Company Website
Does your exhibit area require electric?
Yes
No
Will you attend the FRIDAY evening reception?
Yes
No
I have dietary restrictions
Yes
No
Please specify your restrictions here
Payment
Card Number
CVV
Expire Month
01
02
03
04
05
06
07
08
09
10
11
12
Expire Year
24
25
26
27
28
29
30
31
32
33
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