Registration (Print this page and fill out)

Sponsor levels:

• Gold $1,000 = Two tables in exhibit area, 15 minutes to address conference, passes for 2 people to events, logos on web pages, flyers, printed material and signage.
• Silver $ 500 = One table in exhibit area, 5 minutes to address conference, passes for 2 people to events, logos on web pages, flyers, printed material and signage.
• Bronze $ 250 = One table in exhibit area, pass for 1 person to events, logos on web pages, flyers, printed material and signage.
• Additional Reps (attend all functions) = $ 75.00 each.
• Wednesday Evening Mixer Sponsorship (Cash Bar) = $450 (added signage, web site and flyer publicity during the event)
• Continental Breakfast Sponsorship (Thursday, Feb. 16) = $250 (added signage, web site and flyer publicity during the event)
• Places for Exhibitors is limited to ~ 20, please sign up early. You will be provided with table, cloth, and other booth items except optional items listed below.

Optional Items: (Note: ++ denotes an additional charge of 20% service charge and 9% tax.)

• Phone - analogue phone line @ $161.25 (includes service & tax)
• Standard Power - 110 volt/20amp @ $12.90/day (includes service & tax)
• 28" Data Monitor @ $232.20/day (includes service & tax)
• 27"TV & ½" VHS @ $161.25/day (includes service & tax)
• TV with ½" VHS Combo @ $96.75/day (includes service & tax)

Your Name (for nametag): _________________________________

Company: _________________________________________________

Mailing Address: _________________________________________________________

City,State,Zip ____________________________________________

Phone (_____) _______________________

Fax (_____) _______________________

E-mail: __________________________________________

Check one:
Vendor registration: Circle GOLD, SILVER, BRONZE = Total $___________________

Additional Reps @ $75 _____________ = Total $___________________

To insure signage on printed material, sign up before November 30, 2005
To insure logos on web site, sign up before December 20, 2005.
Deadline for Vendor/Exhibitor sign up is January 25, 2006 OR until 20 booths have been allocated, whichever comes first.

Enclosed is my CHECK (pay to order of ALSSA ) for $ ___________________

Mail form and Payment to:

Make your room reservations at the Wynfrey Hotel early. See main page for information.