Advertising Partnership | OSSPEAC - Ohio Speech Pathology Educational Audiology Coalition

Advertising Partnership Enrollment Form

Company Name *
Address 1 *
Address 2
City *
State *
Zip Code *
Contact Person *
Telephone # *
E-Mail *
Level of Partnership *	Level 1 - OSSPEAC Partner Level 2 - OSSPEAC Conference Partner Level 3 - OSSPEAC Friend
If Level 1 - Which two newsletter do you want your full page advertisement	Fall Winter Spring Summer

I will E-Mail OSSPEAC our company logo and the full-page advertisement.
I will be paying for this partnership by: *	Credit/Debit Check Purchase Order