PHIMA | Pennsylvania Health Information Management Association

"A Little Less Conversation ...
A Little More Action"

Exhibitor Registration Form - Payment

Pay Online by Credit Card

Select "Add to Cart" below and then select "credit card" from the payment options in the shopping cart. After you submit online payment, you will receive an e-mail receipt from KnowledgeConnex, PHIMA's online registration provider. These items will appear as charges from KnowledgeConnex on your credit card statement.

Pay by Check

Select "Add to Cart" below and then select "offline/mail" under payment options in the shopping cart. You will later see instructions to print the invoice page and mail your payment to KnowledgeConnex. The mailing address will be on the invoice. Make your check payable to KnowledgeConnex.

If you need a W-9, please email us.

Select "Add to Cart" below to process your transaction.

Booth	Cost
Basic Single Booth Corporate Sponsor - Click Here For Discount Information
Internet Service	$50
Booth On or Before 2/11/11	$650	Unavailable
Booth After 2/11/11	$775
Premier Single Booth Corporate Sponsor - Click Here For Discount Information
Internet Service	$50
Booth On or Before 2/11/11	$1200	Unavailable
Booth After 2/11/11	$1,375
Double Premier Booth Corporate Sponsor - Click Here For Discount Information - Gold Corporate Sponsors Only
Booth On or Before 2/11/11	$1500	Unavailable
Booth After 2/11/11	$1,675
Additional Tickets	Cost
Basic Single Booth - 2 tickets included for each event listed below Premier Single Booth - 3 tickets included for each event listed below Double Premier Booth- 4 tickets included for each event listed below
Tuesday Morning Breakfast with Vendors	$20
Tuesday Vendor Appreciation Luncheon	$25
Wednesday Business Meeting and Installation of Officers Luncheon (Not included in booth fee. Additional tickets must be purchased)	$25
Sponsorship	Cost
Monday Luncheon	$1500
Monday Afternoon Break	$500
President’s Reception (Monday)	$2,500
President's Reception Entertainment (Monday)	$500
Tuesday Breakfast	$1,000
Tuesday Luncheon	$1500
Networking with Peers Reception (Tuesday)	$1,500
Networking with Peers Reception Entertainment (Tuesday)	$500
Keynote Speaker (Monday or Wednesday)	$1,500
Product Donation – Name Tag Neck Wallets (with your Company Logo)	$1500
PHIMA Scholarship Donation - per student	$500
Binder/Bag	$2500 full
	$1500 partial
Speaker	$300
Donations for events your company does not want to fully sponsor (i.e. President reception entertainment, bags, etc).
Other Sponsorship Amount: $
Balance Due - For Previously Registered Vendors
Enter Balance Due	$