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Options 2001
Registration Form


The Deadline for advertisements, registrations, and sponsorships is May 11, 2001, for inclusion in the Conference Journal. Please print or type the information requested below. Submit a separate form for each registrant by duplicating this form.

Register / Pay with Credit Card by FAX: (502) 625-0082 or Register / Request Invoicing by e-mail: [email protected]

Should you have questions, call (502) 625-0135. Thank you!

Print-out: Duplicate Form and fill out separate for each registrant.

Name

*Company/Organization/Agency
Name for Signage

Address

City

State

Zip Code

Telephone Number

Fax Number


e-mail address

.

*PLEASE NOTE: List Name to appear in printed materials.

THE DEADLINE FOR INCLUSION IN PROGRAM AND JOURNAL IS May 11, 2001.

Only those registered by May 11, 2001, will be listed in printed materials.

All fees are payable in advance. Make check payable to:
KENTUCKIANA MINORITY SUPPLIER DEVELOPMENT COUNCIL

Note: Credit Cards cannot be submitted via this web site.

This form must be filled in, printed out and mailed to KMSDC.

Charge Fee(s) to:

 . Visa
MasterCard
Amex
Discover/Novus

in the amount of

 . $

Account #

 .

Exp. Date

 .

Name of Cardholder

 .

Signature

 .
 

PLEASE PRINT & RETURN REGISTRATION TO:

KMSDC
600 West Main St.
Louisville, KY 40202

 

Questions regarding Registration? Call Teri Hardman at (502) 625-0135, or e-mail to [email protected]

If you cannot attend the Conference, but are interested in KMSDC or membership, please call (502) 625-0135.

HOTEL RESERVATIONS:
Contact: Teri Hardman, [email protected]
KMSDC Director, Corporate and Community Relations
502-625-0147

PARTICIPANT LEVELS

REGISTRATION FEE

QUANTITY DESIRED

 

 

 

Full Conference CORPORATE Sponsorships

Platinum

$10,000

 

Gold

$7,500

 

Silver

$5,000

 

Bronze

$2,500

 

 

 

 

Full Conference MBE Sponsorships

 

MBE Platinum

$3,500

 

MBE Gold

$2,500

 

MBE Silver

$1,500

 

MBE Bronze

$1,000

 

 

 

 

Exhibitor Registration (includes 10' x 10' booth and 1 full Conference Registration)

Corporate Member

$600

 

Corporate Non-Member

$800

 

MBE

$400

 

Govt Agency

$500

 

 

 

 

Full Conference Registration

 

1 admission for reception, breakfast, luncheon, seminars, exhibit hall

Corporate Member

$130

 

Corporate Non-Member

$155

 

MBE

$100

 

Govt Agency

$125

 

 

 

 

Individual Tickets

 

 

Reception

$40

 

Breakfast

$30

 

Luncheon

$60

 

Exhibit Hall Only

$25

 

 

 

 


Company:________________________________
Contact: ________________________

 Address: _________________________________________________________________

 Phone: ______________________ Fax: _________________
- Email: ____________________

 Payment Type: __ Invoice __Check  __Credit Card
(type/number: ________________________)

 Authorized Signature: ____________________________________

 Epiration Date: _______________