DEMENTIACARE2014 Sponsorship and Vendor Commitment Form

Sponsorship and Vendor Commitment Form

Thank you for your interest in the DEMENTIACARE2014 caregiving conference. Use this form to complete payment and reserve your spot! If you are interested in the presenting sponsor level, please contact Grant Fletcher at (315) 472-4201 x106.
Company Name
Contact Name
E-mail
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Please select from the following:
prevnext( X )
Meal Sponsor (includes two vendor admissions)$1,200.00

Will you require electricity?Will you use your vendor table?

Keynote Sponsor (includes two vendor admissions)$750.00

Will you use your vendor table?Will you require electricity?

Event Sponsor (includes one vendor admission)$400.00

Will you use your vendor table?Will you require electricity? (We cannot guarantee access to electricity.)

Expo Vendor (includes one vendor admission)$250.00

Will you require electricity? (We cannot guarantee access to electricity.)

Additional Vendor Admissions$50.00

Total $0.00
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Sponsorship and Vendor Commitment Form