Support Package Pay by Check

$0

Total
Company
Email
Mailing Address Mailing Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Please indicate if you need

Please indicate if you need Oxygen Cylinder (must provide own regulators) Air Cylinder (must provide own regulators) If so, what size? If so, what size?
Will you need an electrical outlet? If so, how many?
I will donate a door prize

I will donate a door prize Yes No
Please indicate the package that your company would like to participate in:(one representative w/ each package included)

Please indicate the package that your company would like to participate in:(one representative w/ each package included) Bronze - Exhibit Booth only; includes one electrical outlet, table, and drape - $900.00 Bronze Plus - Includes Bronze package, one (1) one-day conference admission - $1150.00 Silver - Includes Bronze Plus package, ad in conference rooms - $1450.00 Gold - Includes Silver package, ad in conference rooms and during breaks* - $1700.00 Platinum - Includes Gold Packages, sponsorship for break - $2200 - Break Sponsor Level Virtual Commercial; added to Bronze, Bronze Plus or Silver Package - $250.00 Vendor Commercial - Vendor Commercial with no package; no exhibit booth onsite - $350.00
Additional Table - Add to Above Package - $350.00

Additional Table - Add to Above Package - $350.00 Yes No
Additional Representatives -
Vendor Speaker Sponsorship Packages:

All speaker travel expenses, including air, ground transportation, hotel, and meals
Vendor Receives following: Gold Sponsorship Package Benefits

All speaker travel expenses, including air, ground transportation, and hotel, meals, and Honorarium
Vendor Receives following: Platinum Break Sponsor Level benefits
*My company would like to support the following function or Speaker:
*Speaker sponsorships are on a first come first serve basis.
* Payment must be received prior to meeting date.
Space is confirmed on a first-come first-serve basis.
Please submit payment to:

Lucille Goddard, RRT, RCP
NCSRC
P O Box 1038
Carolina Beach, NC 28428

Check must be received by September 1, 2023
Price $ Dollars . Cents
$0

Total

Exhibit/Advertisement/Support Package Pay by Check

Exhibit/Advertisement/Support Package Pay by Check

$`0`

Total

Vendor Speaker Sponsorship Packages:

*Speaker sponsorships are on a first come first serve basis.

* Payment must be received prior to meeting date.
Space is confirmed on a first-come first-serve basis.

Please submit payment to:

Lucille Goddard, RRT, RCP
NCSRC
P O Box 1038
Carolina Beach, NC 28428

Check must be received by September 1, 2023

$`0`

Total

Exhibit/Advertisement/Support Package Pay by Check

Exhibit/Advertisement/Support Package Pay by Check

$0

Total

Vendor Speaker Sponsorship Packages:

*Speaker sponsorships are on a first come first serve basis.

* Payment must be received prior to meeting date. Space is confirmed on a first-come first-serve basis.

Please submit payment to: Lucille Goddard, RRT, RCP NCSRC P O Box 1038 Carolina Beach, NC 28428 Check must be received by September 1, 2023

$0

Total

$`0`

* Payment must be received prior to meeting date.
Space is confirmed on a first-come first-serve basis.

Please submit payment to:

Lucille Goddard, RRT, RCP
NCSRC
P O Box 1038
Carolina Beach, NC 28428

Check must be received by September 1, 2023

$`0`