2018 Rural Health Legislative Day – Platinum-level Sponsor Online Payment

Platinum Level – $1,000

  • Floor stand banner space
  • Two reps attend free
  • Signage

    First Rep Registration:

    First Name*:

    Last Name*:

    Address*:

    City*:

    State*:

    Zip*:

    County:

    Employer:

    Title/Position:

    Work Phone*:

    Fax:

    Email*:



    Second Rep Registration

    First Name*:

    Last Name*:

    Address*:

    City*:

    State*:

    Zip*:

    County:

    Employer:

    Title/Position:

    Work Phone*:

    Fax:

    Email*:

    Payment Information

    In order to control costs, the Georgia Rural Health Association accepts payments through Paypal. You do not have to join Paypal. Credit cards may be used.

    When you click on the Submit button, below, you will be taken to a page to confirm your membership application information and process your payment.