Page 11 - CONF 2016 Vol 34 No 4
P. 11
2016 TCAPWA & SWANA
Annual Joint Conference
Memphis (Nov. 8-10, 2016)
Exhibitor/ Sponsorship Registration Form
Company Name _______________________________________________Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________State __________________ Zip _____________________
Telephone ________________ Fax __________________ Email ___________________________________________
AGENCY AFFILIATION (check all that apply): __ TCAPWA __ SWANA __ Young Professional (35 and under)
SPONSORSHIP (see Sponsorship Information 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 1) ____________________________________
2) ____________________________________
Vendor Attendee:
Includes 2 w/ each booth or w/ Plat. 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) _______ @ $1,000.00 = ___________
Additional Equipment Space Booth Rental _______ @ $250.00 = ___________
Closing Night Dinner _______ @ $50.00 = ___________
Golf Individual Entry @ Links at Galloway Golf Course (team not available) _______ @ $50.00 = ___________
8am shotgun start (Includes lunch)
TOTAL AMOUNT ENCLOSED ________________
Booth Preference (one paid exhibitor per space)
1st _____________, 2nd _____________, 3rd _____________
Event Hotel: Sheraton Memphis Downtown, (901) 527-7300. Use code “2K05AA” when making reservations. Conference
rate ($129) is available until October 11, 2016. For additional information call Mark Miller at (865) 850-1534 or email
markmiller@charter.net. Make checks payable to TCAPWA and mail to Mark Miller, PO Box 1350, Pigeon Forge, TN
37868 or register online at tennessee.apwa.net to pay with a 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 7th
TCAPWA & SWANA Thank You For Your Support!
Annual Joint Conference
Memphis (Nov. 8-10, 2016)
Exhibitor/ Sponsorship Registration Form
Company Name _______________________________________________Contact ____________________________
Address _________________________________________________________________________________________
City _____________________________________________State __________________ Zip _____________________
Telephone ________________ Fax __________________ Email ___________________________________________
AGENCY AFFILIATION (check all that apply): __ TCAPWA __ SWANA __ Young Professional (35 and under)
SPONSORSHIP (see Sponsorship Information 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 1) ____________________________________
2) ____________________________________
Vendor Attendee:
Includes 2 w/ each booth or w/ Plat. 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) _______ @ $1,000.00 = ___________
Additional Equipment Space Booth Rental _______ @ $250.00 = ___________
Closing Night Dinner _______ @ $50.00 = ___________
Golf Individual Entry @ Links at Galloway Golf Course (team not available) _______ @ $50.00 = ___________
8am shotgun start (Includes lunch)
TOTAL AMOUNT ENCLOSED ________________
Booth Preference (one paid exhibitor per space)
1st _____________, 2nd _____________, 3rd _____________
Event Hotel: Sheraton Memphis Downtown, (901) 527-7300. Use code “2K05AA” when making reservations. Conference
rate ($129) is available until October 11, 2016. For additional information call Mark Miller at (865) 850-1534 or email
markmiller@charter.net. Make checks payable to TCAPWA and mail to Mark Miller, PO Box 1350, Pigeon Forge, TN
37868 or register online at tennessee.apwa.net to pay with a 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 7th
TCAPWA & SWANA Thank You For Your Support!
