Business Partner Form

Company Information

Company Name:
Web Site:
Address:
City:
State:
Zip:
Phone No: (xxx) xxx-xxxx
Fax No: (xxx) xxx-xxxx
Email:
Business Description for Publication:: 2500 characters remaining.

Contact Information

First Name:
Last Name:
Title:
Phone:
E-mail:

Sponsorship and Exhibitor Fees

Exhibitor fees include booth and meals for two representatives. Sponsorship fees include booth and other benefits depending on level - see benefits chart. Level Benefit Chart

SPEAKERS: Any Business Partner selected to present a session or sessions at the conference needs to sponsor.

Sponsorship/Exhibitor Fees:

Will you be using a booth?

Yes
No

Preferred Name for Signage:

Sponsorship/Exhibitor Fees Total:

Booth Information

: Booth Layout
Booth Number Preferred:
Alternative Booth Number:
Second Alternative Booth Number:

Included Representatives

Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)
Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)

Extra Representatives

Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)
Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)
Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)
Name:
Title:
Phone:
E-mail:
Address:: 1000 characters remaining.
: Attending Awards Banquet on Monday evening? ($25 extra)
Award Banquet Fees Total:
Representative Fees Total:

Advertising

Type of Ad:: Onsite Program Advertising Chart
Total Funds to Use for advertising:

Total Due

Sponsorship/Exhibitor Fees Total:
Representatives Fees Total:
Awards Banquet Total:
Advertising Fee:
Grand Total Due:

CASE Conference Planning Admin

For support questions please contact Jeff at Bentvision - 417.597.FIRE

Maintained by: Andrea Mostyn
Supported by: MYBNetworks.com and Bentvision.com