2023 Conference for Michigan's Farmworkers, Service Providers, and Growers

Registration Form

Thank you for your interest in the conference! Please complete the following form to register and request an exhibit table. Payment will need to either by check or money order payable to State of Michigan, by credit card, or by journal voucher. Please indicate your form of payment below. For questions, contact 1-833-SIAYUDA (1-833-742-9832) or email MDHHS-Migrant-Affairs@michigan.gov. Thank you!

Date: November 1st, 2023
Time: Breakfast 8:00-8:30 a.m., Conference 8:30-4:15 p.m.
Location: DoubleTree by Hilton Hotel, 4747 28th St. SE, Grand Rapids, MI 49512

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* 1. Name

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* 2. Email

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* 3. Company/Organization

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* 4. Please indicate if you would like:

Low Sodium Meal

Vegetarian Meal

Other dietary restrictions? Please let us know how we can help

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* 5. Do you require any accommodations for accessibility? (if yes, please specify)

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* 6. Would you like to request having an exhibit table at the conference? If so, please indicate your category below.

Non-Profit Organization ($75 plus $75 registration fee per participant)

For-Profit Organization ($150 plus $75 registration fee per participant)

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* 7. Are you interested in being a conference sponsor? If so, see below for sponsorship levels

Full Harvest Sponsor ($3,000 minimum, includes marketing, display, and program recognition; eight registrations and an exhibit table – please provide logo to contact below)

Spring Planting Sponsor ($1,500 minimum, includes marketing, display, and program recognition; four registrations; and an exhibit table – please provide logo to contact below)

Cultivating Sponsor ($1,000 minimum, includes two registrations and program recognition)

Contributor (Supporting sponsors of $750 to $999, includes one registration and program recognition)

Donation to cover registration fee for a Farmworker or Migrant student ($75 per person)

In-kind Sponsor (Minimum value of donation is $75)

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* 8. Form of Payment

Check or Money Order (Payable to the State of Michigan)

Interagency Billing - See coding here

Credit Card - Visit www.thepayplace.com/mi/dch/conference and use code FARM23

For credit card payments, please enter confirmation code here