Date: Wednesday May 6, 2026Time: 7:30am - 4:00pmLocation: RBC Place, London, Ontario You must have JavaScript enabled to use this form. Please choose one of the following sponsorship levels: Sponsorship: Platinum conference Sponsorship $10,000 (5 available) Unrestricted Educational Grant: The Platinum Conference Sponsors will be highlighted in the Exhibitor Section of the event APP and will also receive the following benefits: - Prime location in the Exhibitor Hall - Enhanced Signage on registration desk, inside the lunch area and on your assigned table - Enhanced appearance on the registration website - 4 Full conference registrations. Gold $5000.00 Unrestricted Educational Grant: The Gold Conference Sponsors will be highlighted in the Exhibitor Section of the event APP and will also receive the following benefits: - Enhanced Signage inside the break area and on your assigned table - Enhanced appearance on the registration website - 3 Full conference registrations. Silver $3000.00 Unrestricted Educational Grant: The Silver Conference Sponsor will receive the following benefits: - Enhanced signage inside the break area and on your assigned table - Enhanced appearance on the registration website and conference App - 2 Full conference registrations Bronze $2000.00 Unrestricted Educational Grant: The Bronze Conference Sponsor will receive the following benefits: - Signage inside the break area - Enhanced appearance on the registration website and conference APP - 1 Full conference registration No sponsorship at this level Our Gold, Silver and Bronze Sponsors will also receive the following benefits:Recognition of support in conference material given to participantsTable-top Signage in the Exhibit space (prime locations are reserved for sponsors)Recognition on prominent conference event signageIncludes all food/beverages provided throughout the day for up to 4 representatives Other Sponsorship Opportunities: Program Sponsor $1,500.00 Your company will receive recognition for providing an education grant towards overall programing of the conference - Table-top signage in the exhibit space (prime locations are reserved for sponsors) - Recognition on prominent conference event signage - Includes all food/beverages provided throughout the day for up to 3 representatives - All other benefits provided Conference Sponsors (listed below) Program Sponsor $700.00 Your company will receive recognition for providing an education grant towards overall programing of the conference - Recognition of support on registration table - Table-top signage in the exhibit space (prime locations are reserved for sponsors) - Recognition on prominent conference event signage - Includes all food/beverages provided throughout the day for up to 3 representatives - All other benefits provided Conference Sponsors (listed below) No sponsorship at this level General Conference Exhibitor (Includes breakfast, lunch, refreshments and break snacks): Commercial Organization ($500.00) Commercial Exhibitors - $450/2 people max ($100/person additional cost). Non-profit Organization $150.00/person (1 person max and additional guests are $100/person) Based on one person attending per Non-profit Organization sponsorship ($100/person additional cost). No sponosrship at this level Benefits of Conference SponsorshipConference sponsors will receive the following benefits(Regardless of the level of sponsorship):- Recognition on Exhibitor Page - Recognition on the conference website (www.sjhc.london.on.ca/events/grd )- Recognition on conference promotional material- Includes 6ft table, 2 chairs, skirting, breakfast, lunch, and refreshment breaksIf you have any questions or would like to discuss details of becoming sponsor or exhibitor please contact Jennifer.whytock@sjhc.london.on.ca. Exhibitor Company/Organization Name: Exhibitor Representative First Name: Exhibitor Representative Last Name: Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. Add additional registrants ($100/pp for both Commercial and NonProfit Exhibitors only): - None -1 registrants2 registrants3 registrants4 registrants5 registrants Additional Registrants: Additional Registrant Name (first and last): Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. Additional Registrant Name (first and last): Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. Additional Registrant Name (first and last): Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. Additional Registrant Name (first and last): Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. Additional Registrant Name (first and last): Email Address: Contact Phone: Do you require any accommodations or dietary restrictions? If so, please specify below. We will do our best to accommodate your needs to ensure a comfortable and inclusive experience. I prefer to pay by: - Select -ChequePaypal/Credit Card Mailing address for cheques: Cheques should be made out to St. Joseph’s Health Care, London – GRD Send to: ATTN: Amy Lane, Division of Geriatric Medicine Parkwood Institute, Main Building PO Box 5777, STN B London, ON N6A 4V2
