45th Annual · April 13-15, 2027

Sponsorship Registration

Invest in mine safety and put your company in front of the people who matter. Every tier includes paid registrations and a company bio featured on our website.

Gold

$1,000

1 registration

Platinum

$2,000

2 registrations

Platinum Plus

$3,000

3 registrations

Diamond

$4,000

4 registrations

Black Diamond

$5,000

5 registrations

Tax-deductible under IRS Code Section 501(c)(3). Submit by March 1, 2027 to guarantee your recognition plaque is printed in time. A W-9 is available on request.

"*" indicates required fields

Comments

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

Company Name:*

Company Address*

Street Address Address Line 2 City State ZIP Code

Primary Person (Point of Contact):*

First Last

Email*

Website

Phone*

Upload Logo

Max. file size: 20 MB.

Company Description and Services*

Please provide a brief description of services and / or products the company offers as soon as possible to post to our “2027 LIST OF SPONSORS" webpage-
NOTE: The SCJMHSC Association is legally established under the laws of Texas as a non-profit organization, donations to help fund it are tax-exempt under IRS Code Section 501(c)(3). Each sponsoring organization or individual will receive a copy (if requested) of the Conference Association’s IRS Form W-9 for tax reporting (charitable donation deduction) purposes.

Select Sponsorship Level*

$5000 Black Diamond Level - Includes 5 paid participant registrations and company bio displayed on our website

$4000 Diamond Level - Includes 4 paid participant registrations and company bio displayed on our website

$3000 Platinum Plus Level - Includes 3 paid participant registrations and company bio displayed on our website

$2000 Platinum Level - Includes 2 paid participant registrations and company bio displayed on our website

$1000 Gold Level - Includes 1 paid participant registration and company bio displayed on our website
Please select level that matched your requested level above for payment.

IRS Code Section 501(c)(3) Statement

The SCJMHSC Association is legally established under the laws of Texas as a non-profit organization, donations to help fund it are tax-exempt under IRS Code Section 501(c)(3). Each sponsoring organization or individual will receive a copy (if requested) of the Conference Association’s IRS Form W-9 for tax reporting (charitable donation deduction) purposes. DISCLAIMER: By Registering for the conference, you understand photographs will be taken and used on our website. All Company and personal information will be protection. WE DO NOT SHARE ANY LIST OF PARTICIPANTS. Thank you for your support!! PLAQUE DEADLINE: To receive a sponsorship plaque, please submit by March 1, 2027 to allow time for printing. HOTEL: Sponsors are responsible for securing their own hotel accommodations. The per diem room rate is $110.00 plus resort fees. To cancel a room reservation, email scjmhscassociation@gmail.com.

Participant #1*
First Last

Phone - Participant #1*

Participant #2*
First Last

Phone - Participant #2

Participant #3
First Last

Phone - Participant #3

Participant #4
First Last

Phone - Participant #4

Participant #5
First Last

Phone - Participant #5

Total

Credit Card*

Sponsorship Registration

Gold

Platinum

Platinum Plus

Diamond

Black Diamond

IRS Code Section 501(c)(3) Statement

Card Billing Information

Explore

Upcoming 2027 Conference

Contact