connect18 - IABC Southern Region Conference Sponsorship Commitment Form
Thank you!
We appreciate your interest in being a sponsor of connect18, our 2018 IABC Southern Region Conference.

This form must be submitted along with sponsorship payment in full prior to receiving sponsor benefits.

Sponsorship Level *
Date *
MM
/
DD
/
YYYY
Company *
Your answer
Alternative Sponsor Listing Name
If other than your company name, indicate how you want to be listed in the roster of sponsors:
Your answer
Primary Contact Name *
Your answer
Mailing Address *
Include city, state or province, and zip code or postal code.
Your answer
Phone *
Your answer
Mobile Phone
Your answer
Fax
Your answer
Email Address *
Your answer
Payment Amount *
List amount to be submitted in US dollars.
Your answer
Check Number *
List the check number we will be receiving via the mail (instructions below)
Your answer
Electronic Signature *
By placement of my name to this form, I affirm this sponsorship committment via electronic signature.
Your answer
Payment Instructions
Checks should be made out to IABC Southern Region and mailed to:

Jordan Nagel, VP, Finance
IABC Southern Region
2714 Audrey Springs Court
Katy, TX 77494

If you prefer to pay by credit card, contact Jordan at treasurer@iabcsouthern.com and she can send you a payment form.

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