ACANE Conference Sponsor Form



Member Sponsor Fee = $450 \| Non-Member Sponsor Fee = $600
The sponsor fee includes registration, breakfast and lunch for two people.
Additional sponsor attendees can register for $75 per person.


Company		Address*
City	*	State* Zip* Phone*


Company Logo	*	Please use the logo you have on file Yes
Company Description (250 word limit)	*


Contractor Raffle
ACA/NE will conduct a contractor raffle during the conference lunch. We would appreciate it if you would donate a prize. Industry-related gifts are preferred.
We will donate to the raflfle.		Yes We will donate:

Attendee Names
Name # 1	*	Email # 1
Name # 2		Email # 2


Additional Attendee Names
Name # 3		Email # 3
Name # 4		Email # 4


Sponsor Payment		Member Sponsorship Non-Member Sponsorship
Additional Attendees		One Attendee Two Attendees

Total Payment		Payment Method * Master Card VISA AMEX
Credit Card #	*	Security # * Mo Exp Yr. Exp
First Name	*	Last Name * Email *



ACA/NE \| 11 Robert Toner Blvd., # 234, North Attleboro, MA 02763 \|508-839-3407 \| www.acane.org \| katie@acane.org