EXHIBITOR APPLICATION AND AGREEMENT LETTER Name:
Title:
Organization/Agency/Company: Address: City:
State/Province:
Zip/Postal Code:
Phone:
Fax:
Cell:
Email Address:
Website:
Exhibitor Fee(s):
$1750.00 for 1 event in 2014 $1575.00 each for 2 events in 2014
Location of Event(s): (see page 2) ____________________________________________________ ____________________________________________________
Fee includes the following Benefits:
• • • • • •
One page promotional piece included in each attendee’s conference kit Logo in the final conference program. USJT.com will link your logo on the specific conference website for the duration of the conference. Receive a special 10% on paid display advertising in Counselor magazine to reach more than 120,000 readers. Counselor Magazine is the official magazine of CAADAC, IC&RC and FADAA. One (1) exhibit table. Four (4) Complimentary Fulltime Conference Registrations for staff or referral sources.
Forms of payment accepted by USJT: Check (payable to US Journal Training, Inc.) Credit Card (VISA, MasterCard, American Express) Cardholder’s name and address exactly as it appears on credit card statement.
Full Payment of $
(please check one)
Credit Card#:
Check
MasterCard
Exp. Date:
Visa
American Express
Security Code:
Name as it appears on card : Billing Address: City:
State/Province:
Cardholder’s Signature: _________________________________
Zip/Postal Code:
Date: _____________________
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Additional Advertising Opportunities:
$2000.00
$1500.00 (Supplied by Sponsor)
$5000.00
Please select which conference(s) would like to attend from the list provided below:
2014 Conference Schedule February 10-13 35th Annual Training Institute on Behavioral Health and Addictive Disorders Hilton Clearwater Beach Resort, Clearwater Beach, Florida March 19-21 6th Annual Counseling Advances Conference: Special track on Co-Occurring Disorders – Treating Eating Disorders and Chemical Dependency The LVH (formerly the Las Vegas Hilton), Las Vegas, Nevada April 24-26 12th National Conference on Adolescents/Young Adults The LVH (formerly the Las Vegas Hilton), Las Vegas, Nevada May 7-9 Southeast Conference on Trauma, Addictions and Intimacy Disorders Doubletree Hotel, Nashville Tennessee May 28-30 27th Annual Northwest Conference On Behavioral Health & Addictive Disorders Hyatt Regency Bellevue, Seattle, Washington September 4-6 5th Behavioral Health &Addictive Disorders Conference Hotel Nikko, San Francisco California September 17-19 (with ethics workshop Sept 16) 20th Annual Counseling Skills Conference Las Vegas, Nevada October 15-17 Adolescents/Young Adults Conference East Coast Doubletree Hotel Center City, Philadelphia, Pennsylvania November 12-14 2nd International Conference on Sex and Love Addiction Weston Beach Resort & Spa, Weston, Florida
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LETTER OF AGREEMENT: It is proposed as follows: 1. Your company/organization will provide U.S. Journal Training, Inc. with $1750.00 Exhibitor fee (when signing up for 2 conferences within the same year, your cost is reduced to $1575.00 for each event). This fee may be paid in two installments (One payment upon signing this agreement and one 45 days prior to the conference) 2. Your company/organization’s logo will be listed in the final conference program. 3. Your company/organization will provide USJT with a one - page promotional piece to be placed in each attendees conference kit (value $300). 4. USJT.com will link your banner/logo on the conference website to your facility. (E-mail LOGO ASAP to lorriek@hcibooks.com) (Your logo should be a minimum of 150 pixels x 80 pixels high). 5. Your company/organization will receive a 10% discount on paid display advertising in Counselor magazine, the official magazine of CAADAC, IC&RC and FADAA (for more info go to www.counselormagazine.com or email advertise@counselormagazine.com). 6. U.S. Journal Training, Inc. will provide your company/organization with exhibit space (value $1750) and four (4) Complimentary Full Time Conference Registrations for staff or referral sources (value of $1596). 7. For your referral sources, complimentary registrations, or for distribution with in your own network, please indicate how many brochures you will need. #______
Cancellations must be received in writing. If you cancel your registration within: • • • •
90 days of the start date of the conference, you will receive a full refund of your sponsorship fee. 60 days of the start date of the conference, you will receive a full refund minus a $250 cancellation fee. 30 days before the start date of the conference, you will receive a full refund minus a $500 cancellation fee. Within 30 days of the start date of the conference, you will receive no refund.
Cardholder’s Signature: _________________________________
Date: _____________________
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Please complete the information below, for your four (4) complimentary registrations for the upcoming conference. (Your guest will receive an emailed confirmation letter)
Exhibitor Name: ____________________________ Company: _______________ Conference Attending: _________________________________________________
1) Name: ______________________ Company: ____________________________ Street Address: _____________________________________________________ City: ___________________________ State: ______ Zip: __________________ Email Address: ______________________ Phone Number: _________________
2) Name: ______________________ Company: ____________________________ Street Address: _____________________________________________________ City: ___________________________ State: ______ Zip: __________________ Email Address: ______________________ Phone Number: _________________
3) Name: ______________________ Company: ____________________________ Street Address: _____________________________________________________ City: ___________________________ State: ______ Zip: __________________ Email Address: ______________________ Phone Number: _________________
4) Name: ______________________ Company: ____________________________ Street Address: _____________________________________________________ City: ___________________________ State: ______ Zip: __________________ Email Address: ______________________ Phone Number: _________________
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