REGISTRATION

Celebrate Science Indiana 2020 will be held on Saturday, October 3rd from 9:30 AM to 5:00 PM. This year's event will be virtual due to the COVID-19 pandemic.

To become a sponsor/exhibitor at Celebrate Science Indiana 2020, please register using the form below.

Upon receiving your registration information, we will send you an invoice for the amount of your sponsorship level. For exhibitors, we would appreciate a donation of $25 to help cover costs on the virtual event.

YOU MUST CLICK THE SUBMIT BUTTON AT THE BOTTOM OF THE FORM TO COMPLETE YOUR REGISTRATION. IF AFTER SUBMITTING YOUR REGISTRATION YOU DO NOT SEE A NEW WEB PAGE WITH THE MESSAGE: "Thanks for registering! We will be in touch with you shortly.", PLEASE CONTACT ROBERT YOST.

* Required entry

Contact Information

Name of person registering*

Name of person registering *

First Last

Organization*

Organization *

Address*

Address *

Street Address Address Line 2 City State Zip Code

Phone number (mobile)*

Phone number (mobile) *

Email address*

Email address *

Name of point-of-contact person the day of the event*

Name of point-of-contact person the day of the event *

First Last

Email address for point-of-contact the day of the event*

Email address for point-of-contact the day of the event *

Sponsor/Exhibitor Information

Choose your level:*

Choose your level: *

Sponsor
Exhibitor

Experience Format*

Experience Format * Please indicate the format(s) for your experiences

Pre-recorded video with Q&A
Live experience
Other

Other format details*

Other Experience Format Details * You selected other format, please describe that format

Number of Experience Time Slots*

Number of Experience Time Slots * Please specify the number of 30 minute time slots you would like to present at. Maximum of 4.

Please enter a number from 1 to 4.

Select Exhibitor/Sponsor Time Slots*

Exhibitor/Sponsor Availability * Please indicate the 30 minute time slots that you are available for.

Exhibitor Donation*

Exhibitor Donation * Please indicate if you would like to make a $25 donation toward the costs of the virtual event.

Count us in for a $25 donation
Unable to make a donation

Select Sponsorship Level*

Select Sponsorship Level *

Select Payment Method

Please indicate your preferred method of payment and we will send you an invoice. DO NOT enter credit card information on this form.*

Select payment method * Please indicate your preferred method of payment and we will send you an invoice. DO NOT enter credit card information on this form. For Sponsors, we will invoice you based on the level of your sponsorship as you selected above. For Exhibitors, if you indicated that you would like to make a $25 donation to help cover virtual event costs, we will invoice you.

Send us an invoice to pay by PayPal (Visa/MC/Discover)
Send us an invoice to pay by check
Other - please specify below

Special Requests

Special Requests

YOU MUST CLICK THE SUBMIT BUTTON BELOW TO COMPLETE YOUR REGISTRATION. IF AFTER SUBMITTING YOUR REGISTRATION YOU DO NOT SEE A NEW WEB PAGE WITH THE MESSAGE: "Thanks for registering! We will be in touch with you shortly.", PLEASE CONTACT ROBERT YOST.

Name

This field is for validation purposes and should be left unchanged.

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REGISTRATION

Contact Information

Sponsor/Exhibitor Information

Select Payment Method