Exhibitor/Sponsor Registration
NEPCSA Professional Development Conference
Friday, September 27, 2019
Tower Square Hotel, Springfield, MA
Company
*
Address
*
City
*
State
*
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AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
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NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code
*
Phone
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Website
Name # 1
*
Email # 1
*
Name # 2
Email # 2
Name # 3
Email # 3
Name # 4
Email # 4
Sponsors: Please send your logo and website address to laura@nepcsa.org.
Please describe your product or services for the booklet. Description Limit = 20 words.
Sponsor Description
Fees
*
Ad Half Page = $100
Ad Full Page = $200
Ad Inside Back Cover = $300
Ad Inside Front Cover = $300
Ad Back Cover = $400
Bronze Sponsor = $300
Silver Sponsor = $500
Gold Sponsor = $750
Platinum Sponsor = $1,000
Extra Person # 1 = $50
Extra Person # 2 - $50
Total
*
Payment
*
Master Card
VISA
AMEX
First Name
*
Last Name
*
Email
*
Zip Code
*
Account #
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Security #
*
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NEPCSA | 11 Robert Toner Blvd., # 234 | North Attleboro, MA 02763
(508) 695-3919 | laura@nepcsa.org
