This packet contains the following documents below: 1) LMSA-Southeast Regional Conference Welcome Letter. 2) Donation Registration Form

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1 This packet contains the following documents below: 1) LMSA-Southeast Regional Conference Welcome Letter 2) Donation Registration Form 3) Recruitment Fair Registration Form If you have any questions about funds being received through the mail, Registration through Paypal, or General Inquiries about the Southeast Regional Conference, then please contact: Conference Chair- Elizabeth Batchelor at If you have any questions about Registration through the website, or General Inquiries about the LMSA SE Region, then please contact: LMSA Southeast Regional Co-Chair- Miguel Gosalbez at

2 Dear Sponsors and Recruiters, It is with great pleasure that we extend an invitation to our network to participate in our 4 th Annual Regional Conference, Pa lante Juntos: Aligning to Discover Health Solutions for Our Communities. The Latino Medical Student Association-Southeast proudly announces that our conference will take place during February 18th, 2012 at the University of Miami Miller School of Medicine, in Miami, FL. The purpose of this event is to bring together pre-medical students, medical students, residents and practicing physicians of the Southeast who are interested in the healthcare needs of Latino communities. This annual event provides participants with an opportunity to network with one another and expand their knowledge of Latino Health issues. The projected conference attendance is over 150 Southeast medical student and pre-medical student leaders. Our mission is to help improve the health of Latinos, and our members are working to find real solutions and to become advocates to benefit our communities. However, our goals cannot be accomplished alone. We are asking for your support and contributions, as they are indispensable to the success of our efforts. There are several ways listed below that you can help. Additionally, this is an excellent opportunity for your Residency Program to recruit a very captive and diverse audience of students culturally and linguistically competent for the growing Latino populations served by your programs. Funds acquired through this request will be applied towards the current conference and also to development and implementation of future regional conference events and scholarships for students pursuing careers in medicine, as well as support of regional chapters programming and community service projects. Please help us in our efforts, vision, and goals to provide an educational forum for Latino medical students and those interested in Latino health care issues. Please refer to the enclosed donor sheets and the residency program registration forms for sponsorship opportunities. If you have any further questions or concerns please do not hesitate to contact Conference Chair Elizabeth Elizabeth Batchelor at EBatchelor@med.miami.edu. Thank you for your consideration. We look forward to hearing from you. Sincerely, LMSA-Southeast Board

3 *** DONATION REGISTRATION FORM *** Annual LMSA-SE Regional Conference, Pa lante Juntos UNIVERSITY OF MIAMI, Miller School of Medicine Miami, Florida Saturday, February 18, 2012 PART A. CONFERENCE CO-SPONSOR (Donation: $2000) The official name and logo of sponsor will be on front cover of conference program Recognition in the conference program for level of support Table for exhibition space during conference 1 year web link on LMSA-Southeast Regional website 15-minutes to present to all conference attendees I want to recruit: ( ) Premed students ( ) Medical Students ( ) N/A What method will you be paying? ( ) Check or money order (by mail) ( ) Paypal SPONSOR (Donation: $3510) Full page mention of organization or company will be placed in conference program Table for exhibition space during conference Recognition in the conference program for level of support 1 year weblink on our website I want to recruit: ( ) Premed students ( ) Medical Students ( ) N/A What method will you be paying? ( ) Check or money order (by mail) ( ) Paypal Friend (Donation: $100) 1 year weblink on our website home page All Friend level sponsors will be listed in the conference program I want to recruit: ( ) Premed students ( ) Medical Students ( ) N/A What method will you be paying? ( ) Check or money order (by mail) ( ) Paypal Non-Residency Exhibitor (Donation: $250 x quantity ) Full six-foot table for exhibition space during conference and designated exposition time 1/15/10. Organizations will also be allowed to sponsor a specific portion of the conference such as the continental breakfast, lunch, or the cost of programs. Contact Elizabeth Batchelor at EBatchelor@med.miami.edu for more information.

4 Donations Wish List: Item Quantity Needed Quantity I Can Furnish Ink pens 150 Pencils 150 Highlighters 150 Notepads 150 Folders 150 Conference Tote 150 Bags Other promotional 150 Items Comments PART B: FOR RESIDENCY PROGRAMS & MEDICAL SCHOOLS ONLY *** Residency Program Registration Form ** Please fill out the form below if you wish to promote a residency program or medical school: EXHIBITION SPACE: FULL SIX-FOOT TABLE 1/15/10 $150 X( quantity) Total $ Special need for set-up: PART C: PROGRAM AND DEPARTMENT ADVERTISEMENT SPACE ONLY: Conference Program Full Page (including 1yr weblink) $100 Conference Program Half Page $ 60 Name and Logo Front Cover of Conference Program $100 LMSA SE Website Program Weblink and Logo 1year $ 40 Listing of Program in Conference Program $ 30 Each full page measurement is 8 x 11 (Please allow for 1 top margin and 0.5 Left/Right margin). Deadline for program advertisements is January 30,2012. Please image files to Elizabeth Batchelor at EBatchelor@med.miami.edu with this completed form.

5 PART D: CONTACT INFORMATION AND PAYMENT, MUST BE COMPLETED. Contribution Grand Total Enclosed $ School name and program name/company name Contact person Position/title Address Address City State Zip code Daytime telephone number PAYMENT INFORMATION Payment Method: Check Money Order Paypal Please this completed form to EBatchelor@med.miami.edu so we are aware of your sponsorship. If paying by Paypal please send payment to lmsa.southeast@gmail.com. If paying by check or money order please mail this completed form and with your payment: Make checks payable to: Latino Medical Student Association Southeast Mail Checks to: Elizabeth Homan-Sandoval 1695 NW 9 th Ave #3100 Miami, FL

6 Sponsorship Checklist (For Personal Use, Do Not Return) 1. [ ]FORMS Complete Parts A-D of forms and documents to EBatchelor@med.miami.edu. 2. [ ]PAYMENT Make an on-line payment via paypal to lmsa.southeast.com OR Send a check or money order. Payable to Latino Medical Student Association Mail all checks to: Elizabeth Homan-Sandoval 1695 NW 9 th Ave #3100 Miami, FL [ ]Registration Register your program s representative(s) attending the conference **If you have questions please us at LMSA.SOUTHEAST@GMAIL.COM **