Page 18 - Sept/Oct 2015 Vol.33 No.3
P. 18
22001155 TTCCAAPPWWAA&&SSWWAANNAA
AAnnnnuuaallCCoonnffeerreennccee
CChhaatttatannooooggaa(N(Noovv. .34-5-5,,22001155))
Exhibitor/ Sponsorship Registration Form
Company Name _______________________________________________ Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________ State __________________ Zip _____________________
Telephone ________________ Fax __________________ Email ___________________________________________
AGENCY AFFILIATION (check all that apply): � TCAPWA � SWANA
SPONSORSHIP (see Sponsorship Submittal sheet for benefits)
• Platinum $2,500 • Gold $1,500
• Silver $1,000 • Bronze $500
_____________________________ = _____________
(event sponsorship level)
Booth Rental (Includes 2 Vendor Attendees) _______ @ $575.00 = _____________
(Only one company per sponsorship and booth)
Vendor Attendee: 1) ____________________________________
2) ____________________________________
(2 included w/ each booth or w/ Platinum sponsorship)
(Includes Branch Reception, Breakfast & Lunch)
Additional Vendor Attendee(s) – (Includes Branch Reception, Breakfast & Lunch) _______ @ $100.00 = _____________
Additional Vendor Attendee Name(s): 3) ____________________________________
4) ____________________________________
5) ____________________________________
Booth Electrical Outlet _____ @ $50.00 = _____________
Equipment Space & Booth Rental (Only one company per sponsorship and booth) _____ @ $1000.00 = _____________
Additional Equipment Space Booth Rental _____ @ $250.00 = _____________
Closing Night Dinner _____ @ $50.00 = _____________
TOTAL AMOUNT ENCLOSED ________________
Booth Preference (one paid exhibitor per space)
1st_____________, 2nd _____________, 3rd _____________
Mail Payment to TCAPWA ATTN: Mark Miller, PO Box 1350, Pigeon Forge, TN 37868
or register online at tennessee.apwa.net to pay with credit card.
INSURANCE IS REQUIRED: VENDORS MUST include with Exhibitor Registration Form and Check a copy of your current
general liability insurance set at a minimum of $1,000,000 per occurrence and $2,000,000 aggregate.
You will not have a booth if payment is not received by the Registration Deadline below.
REGISTRATION
DEADLINE
–
Friday,
October
2nd
AAnnnnuuaallCCoonnffeerreennccee
CChhaatttatannooooggaa(N(Noovv. .34-5-5,,22001155))
Exhibitor/ Sponsorship Registration Form
Company Name _______________________________________________ Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________ State __________________ Zip _____________________
Telephone ________________ Fax __________________ Email ___________________________________________
AGENCY AFFILIATION (check all that apply): � TCAPWA � SWANA
SPONSORSHIP (see Sponsorship Submittal sheet for benefits)
• Platinum $2,500 • Gold $1,500
• Silver $1,000 • Bronze $500
_____________________________ = _____________
(event sponsorship level)
Booth Rental (Includes 2 Vendor Attendees) _______ @ $575.00 = _____________
(Only one company per sponsorship and booth)
Vendor Attendee: 1) ____________________________________
2) ____________________________________
(2 included w/ each booth or w/ Platinum sponsorship)
(Includes Branch Reception, Breakfast & Lunch)
Additional Vendor Attendee(s) – (Includes Branch Reception, Breakfast & Lunch) _______ @ $100.00 = _____________
Additional Vendor Attendee Name(s): 3) ____________________________________
4) ____________________________________
5) ____________________________________
Booth Electrical Outlet _____ @ $50.00 = _____________
Equipment Space & Booth Rental (Only one company per sponsorship and booth) _____ @ $1000.00 = _____________
Additional Equipment Space Booth Rental _____ @ $250.00 = _____________
Closing Night Dinner _____ @ $50.00 = _____________
TOTAL AMOUNT ENCLOSED ________________
Booth Preference (one paid exhibitor per space)
1st_____________, 2nd _____________, 3rd _____________
Mail Payment to TCAPWA ATTN: Mark Miller, PO Box 1350, Pigeon Forge, TN 37868
or register online at tennessee.apwa.net to pay with credit card.
INSURANCE IS REQUIRED: VENDORS MUST include with Exhibitor Registration Form and Check a copy of your current
general liability insurance set at a minimum of $1,000,000 per occurrence and $2,000,000 aggregate.
You will not have a booth if payment is not received by the Registration Deadline below.
REGISTRATION
DEADLINE
–
Friday,
October
2nd
