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Organization Name :_______________________________________________________

Representative’s Name :____________________________________________________

Representative’s Mailing Address:____________________________________________

City:__________________________________ State:____  Zip:  ___________________

Phone:_____________________  Fax: ________________  Email:__________________

Contact name on site (if different):____________________________________________

Are you interested in being a general sponsor (i.e. providing an unrestricted gift)?

                Yes             No   Amount $               

Sponsorship/Exhibit Options
(Please Check)		 Option Costs
         Platinum
         Platinum sponsorship provides one school registration, free exhibit space, full page ad in student packet.		 $3,000
         Gold    
         Gold sponsorship provides one school registration, 75% off exhibit space, full page ad in student packet.		 $2,000
         Silver
           Silver sponsorship provides one school registration, 50% off exhibit space, half page ad in student packet.		 $1,000
          Bronze   
          Bronze sponsorship provides 25% off exhibit space, quarter page ad in student packet.		 $750
 

Are you interested in sponorship of a specific/event function?             Yes            No

      

      

          Refreshment Break ($550)

          Special Speaker ($2,000)
 

          Packet Printing ($1,500)

          Banquet ($2,500)
 
 

Are you interested in advertising in School Materials?             Yes            No
 Select one

      

      

          Full Page (8.5 x 11")

$325 (Complimentary with Platinum or Gold Sponsorships)
 

          Half Page (8.5 x 5.5")

$195 (Complimentary with Silver Sponsorship)
 

          Quarter Page (4.25 x 5.5")

$125 (Complimentary with Bronze Sponsorship)
 

Are you interested in being an Exhibitor at the School?  

         One Day Exhibit Fee (Monday)       



$100

         Four Day Exhibit Fee (Tues-Fri)

$400

         Five Day Exhibit Fee (Mon-Fri)

$475

Payment must accompany this form. Total amount enclosed or charged: $____________

Payment Method:  ___ Check       ___ Visa      ___ MasterCard     ___ American Express

Card Number: _________________________________  Expiration Date: _____________

Authorized Card Holder: _____________________________________________________

Signature: __________________________________________________________________

 Please make checks payable to NCFADS and return with this form no later than July 11, 2009 to:
 NCFADS, PO Box 4024, Wilmington, NC 28406.