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2023 Spring Conference Registration

2023 Spring Conference RegistrationMary McGinn2023-03-14T10:19:46-04:00

Conference Dates: May 31- June 2, 2023

Please Use This Registration Form to Sign Up to Attend (Conference and/or Golf), Exhibit, and/or Sponsor the MSIA 2023 Spring Conference. After Registering, See Our Lodging Page to Book a Hotel Room.

Registration Form

If You Need to be Invoiced for Your Registration Instead of Paying Online, Please Email Our Event Partner at mary@associationguidance.com

Type of Registration(Required)

Are You a Member of MSIA?

Type of Membership

Industry Category

Self-Insured Employer or Group Fund (Self-Insured) Quantity

Price: $250.00

Quantity

Self-Insured Employer or Group Fund (Self-Insured) Quantity

Price: $300.00

Quantity

Member Vendor (Provider, TPA, PI, IME, NCM, Other) Quantity

Price: $400.00

Quantity

*Does not include booth

Non-Member Vendor (Provider, TPA, PI, IME NCM, Other) Quantity

Price: $600.00

Quantity

*Does not include booth

Member Attorney Quantity

Price: $400.00

Quantity

*Does not include booth

Non-Member Attorney Quantity

Price: $600.00

Quantity

*Does not include booth

Exhibit Booth - MSIA Member Quantity

Price: $500.00

Quantity

*Includes 1 Representative and Booth

Additional Member Representatives Quantity

Price: $250.00

Quantity

Exhibit Booth - Non-Member Quantity

Price: $750.00

Quantity

*Includes 1 Representative and Booth

Additional Non-Member Representatives Quantity

Price: $300.00

Quantity

Sponsorship Opportunities

Diamond Sponsor (5 Available) $3,000.00 *Includes Exhibit Booth and 3 Attendee Registrations

Platinum Sponsor (10 Available) $2,000.00 *Includes Exhibit Booth and 2 Attendee Registrations

Gold Sponsor (20 Available) $1,500.00 *Includes Exhibit Booth and 1 Attendee Registration

Wednesday Welcome Reception Sponsor (4 Available) $1,000.00

Thursday Farewell Party Sponsor (4 Available) $1,000.00

Silver Sponsor (Unlimited) $750.00

Lunch Sponsor (4 Available) $500.00

Breakfast Sponsor (4 Available) $350.00

Board Dinner Sponsor (1 Available) $350.00

Break Sponsor (3 Available) $350.00

*You may purchase more than one type of sponsorship however you will need to either fill out registration more than once or you can email mary@associationguidance.com and we will sign you up manually.

Discounted Additional Attendee Registration Quantity

Price: $250.00

Quantity

Do You Need to Purchase Attendee Registration(s)?

Membership Type

Industry Category

Self-Insured Employer or Group Fund (Self-Insured) Quantity

Price: $250.00

Quantity

Self-Insured Employer or Group Fund (Self-Insured) Quantity

Price: $300.00

Quantity

Member Vendor (Provider, TPA, PI, IME, NCM, Other) Quantity

Price: $400.00

Quantity

Non-Member Vendor (Provider, TPA, PI, IME, NCM, Other) Quantity

Price: $600.00

Quantity

Member Attorney Quantity

Price: $400.00

Quantity

Non-Member Attorney Quantity

Price: $600.00

Quantity

Would You Like to Register for Golf on Friday, June 2, 2023?(Required)

*8:30 am Shotgun Start. Limited to 40 Golfers.

Golf Quantity

Price: $135.00

Quantity

*If you do not sign up with a foursome, we will assign you to one.

Additional Golfers - If You Are Purchasing Golf For Multiple People, Please Provide the Names and E-mails for Any Additional Golfers

Registration Total

Company(Required)

Name(Required)

First Last

Job Title(Required)

Email(Required)

Phone(Required)

Additional Registrants - If You Are Purchasing Multiple Registrations, Please Provide the Names and E-mails for Any Additional Registrants

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credit Card

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Questions? Reach out to Association Guidance, our Event Partner, at 517-333-3628 or mary@associationguidance.com

MICHIGAN SELF-INSURERS’ ASSOCIATION (MSIA)
3001 W. Big Beaver Road, Suite 206Troy MI 48084Email: msia.michigan@gmail.com

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