Organisation / business name *

Note: if your organisation or business name is different from your own name, please enter the entire name of the organisation/business into the "First Name" box, and type "N/A" into the "Last Name" box.

First Name

Last Name

Please select your chosen / preferred sponsorship tier *

Seed – $250+

Sprout – $1,000+

Frond – $2,500+

Tree – $5,000+

Forest – $7,500+

I'd like to discuss a custom sponsorship option

How would you like your name and/or logo to appear on materials? *

Please tell us how you’d like your organisation (or yourself) to be recognised in sponsor materials (e.g. full organisation name, shortened name, individual name, name and logo, logo only, anonymous, etc.).

Name only

Logo only

Name and logo

I would like remain anonymous

Other

Confirmation of consent for public acknowledgement / recognition *

Yes, I consent to being publicly acknowledged as a sponsor, as described in the sponsorship prospectus.

No, I would like to remain an anonymous sponsor (I do not consent to being publicly acknowledged).

Please read the following statements, then mark your response in the appropriate checkbox. *

By completing this form, I confirm that the following: 1) I/my organisation is not affiliated with, does not endorse, and does not participate in: – Weight-loss companies or programs, or BMI-based programs. – Conversion-based or coercive behavioural approaches. – Practices or programs that conflict with the values of the Appetite for Change Conference (e.g. our values of and commitments to anti-ableist, anti-racist, anti-colonial, neurodiversity-affirming, LGBTQIA+ affirming, body and weight inclusive, equitable care). – Movements or belief systems that are pro-genocide, pro-war, right-wing, discriminatory, and/or extremist in nature. 2) I/my organisation understand that sponsorship does not and will not influence speaker selection, program content, or abstract acceptance.

Yes, I confirm this

No, I do not confirm this

Payment Information *

Please indicate your preferred method for payment / sending sponsorship funds.

Direct bank transfer

Invoice to finance team

Other

Additional discussions, options, and/or questions?

Please note, this section is optional. If you fill it out, you are welcome to select any / all that apply.

I'd like to discuss a custom sponsorship option

I'd like to fund additional free tickets for community allocation (further to sponsorship funds)

I'd like to arrange a personal call/online meeting together (this is at no cost)

Confirmation of Information *

I confirm that the information I have provided in this form is accurate and true to the best of my knowledge.

Yes, I confirm this