Note: Leaving a contribution for Zeffy is optional. if you do not wish to donate an additional amount, you can select "other" using the drop-down bar and enter $0.00.

Hello! You are agreeing to mail a check payment in the amount of $40.00 to IPHNA. Checks can be made out to IPHNA. Please print this form prior to selecting "Confirm" at the bottom of the page and submit it with your payment. Mail this form and check payment to: Robin Hannon IPHNA Treasurer 29 Ednick Dr. Swansea, IL 62226

Includes: - Company Logo on Flyers - Table at Event Note: Leaving a contribution for Zeffy is optional. if you do not wish to donate an additional amount, you can select "other" using the drop-down bar and enter $0.00.

Includes: - Company Logo on Flyers - Table at Event Hello! You are agreeing to mail a check payment in the amount of $200.00 to IPHNA. Checks can be made out to IPHNA. Please print this form prior to selecting "Confirm" at the bottom of the page and submit it with your payment. Mail this form and check payment to: Robin Hannon IPHNA Treasurer 29 Ednick Dr. Swansea, IL 62226

Includes: - Company Logo on Flyers - Table at Event - 15 Minute Speaker spot Note: Leaving a contribution for Zeffy is optional. if you do not wish to donate an additional amount, you can select "other" using the drop-down bar and enter $0.00.

Includes: - Company Logo on Flyers - Table at Event - 15 Minute Speaker spot Hello! You are agreeing to mail a check payment in the amount of $350.00 to IPHNA. Checks can be made out to IPHNA. Please print this form prior to selecting "Confirm" at the bottom of the page and submit it with your payment. Mail this form and check payment to: Robin Hannon IPHNA Treasurer 29 Ednick Dr. Swansea, IL 62226

Includes: - Company Logo on Flyers - Table at Event - 30 Minute Speaker spot Hello! You are agreeing to mail a check payment in the amount of $500.00 to IPHNA. Checks can be made out to IPHNA. Please print this form prior to selecting "Confirm" at the bottom of the page and submit it with your payment. Mail this form and check payment to: Robin Hannon IPHNA Treasurer 29 Ednick Dr. Swansea, IL 62226

Includes: - Company Logo on Flyers - Table at Event - 45 Minute Speaker spot Hello! You are agreeing to mail a check payment in the amount of $1,000.00 to IPHNA. Checks can be made out to IPHNA. Please print this form prior to selecting "Confirm" at the bottom of the page and submit it with your payment. Mail this form and check payment to: Robin Hannon IPHNA Treasurer 29 Ednick Dr. Swansea, IL 62226