(HT) Facilities 2014 Applications - 01/15/14

PLEASE FAX COMPLETED FORM TO BASA at 614-846-4081 NO LATER THAN JANUARY 15, 2014 2014 BASA School Facilities Conference Sponsorship/Door Prize Contract March 12 & 13, 2014 Doubletree Hotel-Worthington

Company/Organization ___________________________________________________________ Contact Name and Title ________________________________________________________________ Address ______________________________________________________________________________ City, State, Zip ________________________________________________________________________ Phone Number____________________________Fax_________________________________________ Email ________________________________________________________________________________ If you wish to have name badges made for the conference, please give names and titles (WE MUST HAVE TITLES) below. (If you are already hosting an exhibit booth, there is no need to give this information again.) 1.___________________________________ 2.___________________________________ 3.___________________________________ 4.___________________________________ Sponsorship Options:

□ $2,500 Full Sponsorship □ $2,500 Full Sponsorship □ $1,500 Full Sponsorship □ $1,500 Full Sponsorship

□ $1,250 Co-Sponsorship □ $1,250 Co-Sponsorship □ $750 Co-Sponsorship □ $750 Co-Sponsorship

Breakfast: Wednesday, March 12 Breakfast: Thursday, March 13

Morning Break: Wednesday, March 12 Morning Break: Thursday, March 13

□ $3,500 Full Sponsorship

□ $1,750 Co-Sponsorship

Lunch: Wednesday, March 12

□ $1,500 Full Sponsorship □ $5,000 Full Sponsorship

□ $750 Co-Sponsorship □ $2,500 Co-Sponsorship

Afternoon Break: Wednesday, March 12

Reception: Wednesday, March 12

Donation Options: My company would like to donate the following item(s) to be used for the door prize drawing at the 2014 BASA School Facilities Conference . I understand that my company will be recognized during the drawing for the donation. _____________________________________________________________________________________________

_________________________________ Company Representative Name

_______________________________ Company Representative Signature