Corporate Sponsorship and Membership

Use this Form to become a Sponsor (and sign up your free forum attendee that comes with Sponsorship) or to become a Member.

Note: If you are already a Sponsor or a Member and just want to register more people for the conference - click here.

  1. Submit your registration information FIRST before paying.
  2. If you are paying by CHECK; send to the address below.
  3. To pay by CREDIT CARD, after submitting the registration form(s), use the BROWSER BACK button to return to the Registration page and click on the Pay By Credit Card link.

Select One

SELECT ONE
  

2009 Sponsorship

Includes
Corporate Membership
1 Forum Registration

$1000

Are you sending someone to the Forum?
Then DON'T FORGET to complete the Forum Registration Info below!

2009 Corporate Membership
ONLY

$250

Forum Registration
Member: $349
Non-Member $525


Click Here For

Non-Member
Forum Registration

or

Register Additional Forum Attendees
 

Membership Period runs from 1/1/2009 - 12/31/2009

Membership/Sponsorship Registration

Company Name
Other Companies Represented (if any)
Contact Person for Membership/Sponsorship
Title of Contact Person
Company Street Address
City
State
Zip
 
Contact Email Address
Contact Phone #
Fax No
 
Forum Attendees Registration (for 1st free attendee with Sponsorship Only). If you have other people to register, submit this form and then go to the additional registrations form.
ALL FIELDS MUST COMPLETED!!  
1st Conference Attendee  
Name
Name to Appear As On Badge
Title
Address
City
State
Zip
  
Contact Email Address
Contact Phone #
Fax No
Company Operational Areas (may indicate more than 1)
I will attend Wed night welcome reception Yes   
No		 I will attend Wed night welcome dinner Yes
No
   

Are you paying by check?

  
Make Check Payable to:
LTCIF Forum, Inc. (Federal Tax
ID 75-287 4444)		 Mail to:
Becky Freeman, Treasurer
2380 Deerpath Circle
Neenah, WI 54956
   

I'm Done! What do I do?

Send this information NOW.
Then use the browser BACK button to return here if you are paying by credit card.

I want to register more forum attendees!

Submit this information NOW.
Then use the browser BACK button to return here and then click this link to register additional people for the forum. Take this link ONLY if you submitted your registration: Register Additional Forum Attendees

I want to pay by credit card!

Take this link ONLY if you submitted your registrations: Pay By Credit Card
 

 

 

Membership/Sponsorship Registration
Company Name
Other Companies Represented (if any)
Contact Person for Membership/Sponsorship
Title of Contact Person
Company Street Address
City
State
Zip
 
Contact Email Address
Contact Phone #
Fax No
 
Forum Registration - for the 1st free attendee with Sponsorship Only.
ALL FIELDS MUST COMPLETED!!
Name
Name to Appear As On Badge
Title
Address
City
State
Zip
  
Contact Email Address
Contact Phone #
Fax No
Company Operational Areas (may indicate more than 1)
     
     
   
I will attend Wed night welcome reception Yes   
No		 I will attend Wed night welcome dinner Yes
No
   
Are you paying by check?
Make Check Payable to:
LTCIF Forum, Inc. (Federal Tax
ID 75-287 4444)		 Mail to:
Becky Freeman, Treasurer
2380 Deerpath Circle
Neenah, WI 54956
   
I'm Done! What do I do?

Submit this information NOW.
Then use the browser BACK button to return here if you are paying by credit card.

I want to register more forum attendees!

Submit this information NOW.

Then use the browser BACK button to return here and then click this link to register additional people for the forum. Take this link ONLY if you submitted your registration: Register Additional Forum Attendees

I want to pay by credit card!

Take this link ONLY if you submitted your registrations: Pay By Credit Card