Become a Sponsor *Applications for sponsorship are accepted NOW through March. View 2025 Sponsorship Levels Here Thank you for your support! 2025 Sponsorship (NEW) 2025 Sponsorship level selections, contact, and payment process. Step 1 of 5 20% This field is hidden when viewing the form2025 Sponsorship Contact InformationPlease enter the sponsoring forms contact information. Include the point of contact that the sponsorship committee need to reach out to for all your sponsorship benefits.Company Name(Required)Website(Required) Sponsorship Level(Required) Diamond (Statewide) - $3,600 Platinum (Statewide) - $2,700 Gold (Single Chapter) - $1,200 Silver (Single Chapter) - $600 Hospital Friend (Only available to Healthcare Providers, Single Chapter) - $325 Friend (Single Chapter) - $300 LogoAccepted file types: jpg, jpeg, png, gif.Please upload a high-resolution PNG or JGP of your logo. PNG with transparent background is preferred.Logo (Print)Accepted file types: jpg, jpeg, png, gif.Please upload the vector version of your logo (inPDF or SVG format). Note: please DO NOT save a JPG or PNG as a PDF. Ask you marketing department for vector PDF of SVG.Logo Trouble? I’m having trouble uploading my logo. Please email me. (Please note, we cannot display your sponsorship on the website until we have a logo file) Complimentary MembershipListFull Name (first line)Email (second line) Add RemovePlease add the name and email addresses for the complimentary membership as included with your sponsorship level. Add your to two additional lines as needed for your sponsorship level.Please select the Chapter you would like to be assigned to.(Required)Central Texas ChapterDallas/Fort Worth ChapterHouston ChapterNote: Statewide sponsors need to select their primary chapter to coordinate sponsorship benefits. Name(Required) First Last Email(Required) Billing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Total Payment Method(Required) Check Credit Card Checks can be made payable to Women in Healthcare - Texas Chapter Please mail payment to: ATTN: Ana Hutchins 350 N Saint Paul St., #100 Dallas, Texas 75201 Credit CardCard Details Cardholder Name