SPONSOR/EXHIBITOR/ADVERTISER/DONOR

REGISTRATION

COMPANY NAME:

COMPANY ADDRESS:

CONTACT PERSON:

PHONE #:

E-MAIL:

q   PLATINUM LEVEL SPONSOR - $2,000

q   DIAMOND LEVEL SPONSOR - $1,000

q   EMERALD LEVEL SPONSOR - $500

q   EXHIBIT BOOTH - $75 (If not participating as a sponsor)

q   AFFILIATE BOOTH - $50 (ACB affiliates and chapters)

q   FULL PAGE ADVERTISEMENT IN PROGRAM - $100

q   HALF PAGE ADVERTISEMENT IN PROGRAM - $75

(If not participating as a sponsor)

(All copy must be submitted by October 15.)

q   OTHER IN-KIND DONATION (PLEASE SPECIFY) ________________

If you need electricity or have any other requirements, please contact Terry Pacheco at terrypach@aol.com or call 301-608-3346. 

Please make checks payable to ACB of Maryland, and remit with this form to:

Terry Pacheco

1220 East West Highway, #624

Silver Spring, MD 20910

Thank You Very Much for Your Participation!