2014 Texas and Oklahoma Workers Comp Forum October 9-10, Hilton Anatole, Dallas Sponsor / Exhibitor Registration Form.

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1 2014 Texas and Oklahoma Workers Comp Forum October 9-10, Hilton Anatole, Dallas Sponsor / Exhibitor Registration Form. Company (This is how your company name will appear on all marketing materials..) Phone EXHIBIT PACKAGE Early Bird Discount, by June 6, $ 1,799 Early Bird Discount, by August 22, $ 1,999 Standard Price... $ 2,299 Add insert to registration bag... $ 295 Exhibit packages include: 10x10 space including electric, 6 skirted table, 2 chairs, wastebasket 2 staff passes with full conference access Receipt of conference attendee list with complete contact information (including and phone Logo, 100-word profile and link to your organization on conference Logo and 100-word profile in event guide Additional staff passes available for $750 each SPONSORSHIP PACKAGES For full benefits listing, please see pages 3-6. Executive Speaking Sponsor... $ 4,499 Daily Schedule Sponsor... $ 3,499 Cocktail Reception Sponsor... $ 3,999 Luncheon Sponsor Day One: October 9... $ 3,999 Day Two : October $ 3,499 Breakfast Sponsor, Ocotober $ 3,499 Refreshment Break Sponsor October 9, Afternoon... $ 3,499 October 10, Morning... $ 3,499 Registration Bag Sponsor... $ 3,999 Lanyard Sponsor (logo on lanyard)... $ 3,999 Attendee Badge Sponsor (logo on badge)... $ 4,499 Attendee Gift Sponsor (Gift and bag provided by sponsor) Handed out at hotel check-in... $ 2,499 Delivered to attendees room... $ 2,499 SPONSORSHP PACKAGES continued Registration Area Sponsor... $ 4,499 Registration bag insert (Does not include Exhibit benefits)... $ 799 With one attendee pass... $ 1,499 Exhibit Package... $ Sponsorship Package... $ Add insert to registration bag... $ TOTAL... $ Terms, Conditions, and Payment: The Conference Board will invoice you for this amount unless you choose to pay by credit card. The sponsorship fee is non-refundable. Signature Payment Credit Card: Date Visa MasterCard Discover AMEX Card No. Exp. Date Authorized Signature Security (CVV) Code A paid invoice will be sent to you when the credit card charge has been accepted. Bill me: Contact, company and address if different from above: Mailing in payment. Checks payable to The Conference Board. (Reference TXOKWC, K07015) Mail to: Yeonis Rondon, The Conference Board, 845 Third Avenue, NY NY

2 Attendee Registration & Badge Form All exhibitors receive 2 complimentary passes (good for expo hall, all sessions, food, refreshments and all networking events). Some sponsorship options come with additional passes. For details on number of passes, please see pages 4-8. Please fill out and to sam.norton@conference-board.org or fax to (212) All registered attendees will receive an confirmation with logistical details. If you would like to purchase additional passes, please contact Amy Thyberg, (212) , amy.thyberg@conference-board.org. Company : As you would like it to appear on attendee badge. Attendee #1 Phone Fax Attendee #2 Phone Fax Attendee #3 Phone Fax Attendee #4 Phone Fax

3 PACKAGE DETAILS, Texas and Oklahoma Workers Comp Forum Exhibit Package 10x10 space in exhibit hall, including electric, 6 skirted table, 2 chairs Receipt of 2 complimentary passes to the conference Company name, logo, and 100-word profile listed on conference along with a link to your Price: $2,299 Early Bird (by June 6, 2014): $1,799 Early Bird (by August 22, 2014): $1,999 Add collateral to registration bag: $295 Executive Speaking Sponsor 60-minute speaking position in concurrent-session slot on topic of your choice (not including speakers) Company name, logo, and 100-word profile listed on conference along with a link to your Logo on signage outside session room Price: $4,499 Daily Schedule Sponsor Logo prominently displayed on cover of Daily Schedule (non-exclusive) Receipt of 3 complimentary passes to the conference Receipt of conference attendee list with complete contact information (including name, title, company, mailing address, and phone approximately 2 weeks after the event ends Company name, logo, and 100-word profile listed on conference along with a link to your Price: $3,499

4 Cocktail Reception Sponsor On-site signage provided during reception as well as special mention during prize drawings Company name and logo in all conference promotional materials listing indicating sponsorship participation in reception Company name, logo, and 100-word profile listed on conference along with a link to your Price: $3,999 Luncheon Sponsor Signage in luncheon room/area indicating your sponsorship with company name and logo Company name, logo, and 100-word profile listed on conference along with a link to your Price: Day One, October 9: $3,999 Price: Day Two, October 10: $3,499 Breakfast Sponsor Signage in breakfast area indicating your sponsorship with company name and logo Receipt of 3 complimentary passes to the conference Company name, logo, and 100-word profile listed on conference along with a link to your Price: $3,499

5 Refreshment Break Sponsor Signage in break area indicating your sponsorship with company name and logo Receipt of 3 complimentary passes to the conference Company name, logo, and 100-word profile listed on conference along with a link to your Price: Day One, October 9: $3,499 Price: Day Two, October 10: $3,499 Registration Bag Sponsor Logo on bag given out at registration Company name, logo, and 100-word profile listed on conference along with a link to your Price: $3,999 Lanyard Sponsor Logo and company name printed on lanyard for conference badge Company name, logo, and 100-word profile listed on conference along with a link to your Price: $3,999

6 Attendee Badge Sponsor Logo and company name on badges Company name, logo, and 100-word profile listed on conference along with a link to your Price: $4,499 Attendee Gift Sponsor (Gift at Check In, or Gift Delivered to Guest Room) Gift bag including collateral and gifts given to each attendee staying at the hotel at check in or delivered to their room (gift or gift bag and contents provided by sponsor) 10x10 space in exhibit hall, including electric, 6 skirted table, 2 chairs Receipt of 2 complimentary passes to the conference Company name, logo, and 100-word profile listed on conference along with a link to your Price: $2,499 Registration Area Sponsor Logo and company name on signage in registration area and on registration booths Double booth space x20 display area during conference in the exhibit hall Company name, logo, and 100-word profile listed on conference along with a link to your Price: $4,499 Registration Bag Insert Sponsor Advertisement, collateral and/or gift placed into registration bag (provided by sponsor) Price: $799 Price with one attendee pass: $1,799 Price for exhibitors / sponsors to add this option: $295 Previous Sponsors, please contact: Sam Norton Phone: Fax: sam.norton@conference-board.org New Sponsors, please contact: Amy Thyberg Phone: Fax: amy.thyberg@conference-board.org