One moment please...
Adolescent Symposium 2023 Sponsorship
Contact Information
*

First Name
Last Name
*

*

*

*

If invoice needs to go to someone other than the main contact, please provide:
*

*

*

Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country
*

*
I agree that I am an approved representative of my organization to accept sponsorship information and processing.
*
All sales are final, No Refunds. Payment Terms are credit card or Net 30 from the date of this form. Late Payments may incur a fee. Photography, audio, or video recording is strictly prohibited without written permission from MHA of Greater Dallas. No outside Food or Beverages are allowed, except candy at your table to give away. CDC Guidelines will be in place as needed.