WVHIMA Website Advertising

Click here to learn more about the website advertising options and pricing.

Vendor will be contacted by WVHIMA regarding payment once approved by the WVHIMA Board of Directors.

1. Submission Type *This question is required.

2. Corporation Name *This question is required.

3. Type of Business

4. Corporation Representative

First Name *This question is required.

Last Name *This question is required.

Title

Street Address

Suite/Office

City

State

Zip

Email Address *This question is required.

Phone Number *This question is required.

Fax Number

Website Address

5. Brief description of your company and services (30 words or less). *This question is required.

6. Logo or banner

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