Sponsorship Group/Organization: ______________________________________________________________________________________ Contact Name: ______________________________________________
Title: __________________________________________________
Address: ________________________________________________________________
State/Prov.: _________________________________________________
Postal Code: ___________________________________________
Country: ____________________________________________________
E-mail: ________________________________________________
Organization name as it should appear in publications and signage:
___________________________________________________________________________
Please mark you preferences for sponsorship:
[ ] Premier Sponsor $25,000
[ ] Main Sponsor $15,000
[ ] Reception/Break Sponsor $15,000
[ ] Associate Sponsor $7,500
[ ] Agency/AFBF & NASDA Chapters $5,000
[ ] Conference Totebag Sponsor $10,000
Sponsorship levels include benefits listed in this brochure. Each sponsorship requires a 50% deposit
at time of agreement. Remaining balance will be invoiced and is due 30 days from date of agreement.
Do you wish linkage to the conference Web site:
[ ] Yes, URL _____________________________________________
[ ] No
Webmaster contact name: ________________________________ Phone No.: (_____) _________________
How many company representatives and clients do you anticipate will attend? _____
Indicate type of payment: [ ] Check [ ] Bank Wire [ ] Credit Card
If paying by credit card, please complete the following information:
Card Type: [ ] Visa [ ] MasterCard [ ] American Express Amount: $______________
Name on the card: ___________________________________ Signature: _____________________________
Card Number: _______________________________________ Expiration Date: ________________________
If paying by bank wire, remit funds to:
SunTrust Bank, Atlanta, Georgia, USA: ABA# 061000104, account 4000740318
Make all fees payable to: Conway Data, Inc.
Mail or Fax this form to
Conway Data, Inc.
35 Technology Park, Suite 150, Norcross, GA 30092 USA
Fax: 1-770-263-8825
Tel: 1-770-446-6996
*Benefits are based on current program format and may vary if changes occur. Please mark your preferences for
sponsorship. All sponsorship levels will be granted based on availability, date of receipt of deposit and acceptance by Conway Data, Inc.
In the unlikely event the conference is cancelled, all sponsorship and registration fees will be fully refunded.
All transportation, hotels and other third party arrangements are not covered by this agreement.