Quality of health information on the Internet (QHII)
Become sponsor

Name: ________________________________________________________

Title: _________________________________________________________

Company: _____________________________________________________

Address: ______________________________________________________

City/state: ___________________________ ZIP _______________________

Tel: _________________________ Fax: _____________________________

Email: ________________________________________________________

The best time to contact me is: _____________________________________

The best way to contact me is: Telephone Email Fax
I'm interested in the following sponsorship oppportunities:

Institute (sustaining sponsorship)

Quality of health information on the Internet (QHII) program

Health Website Rating (HWR) project

2007 workshop (in connection with QHII)

Institute award program

 

Aesculapius Awards for excellence in health communications
 

Award for Excellence in Human Research Protection
 

 

Best practice
 

 

Innovation
 

 

Life-time achievement
Other opportunity, please specify below

Remarks/requests — please write below or attach sheet.
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Version 1.1; January 14, 2006