Exhibitor Registration Form sponsored by Missouri Assistive Technology April 21 & 22, 2008 Tan-Tar-A Resort Osage Beach, Missouri Company (As you would like it to appear for signage and promotional purposes.) Contact Person Address City State Zip Code County Phone Fax E-mail Website Representative Name(s) (who will be attending the Expo) A brief description of product/service; and companies that you are a dealer/distributor for: List any probable Exhibitor you wish to be near: List any probable Exhibitor you do not wish to be near: If your company is interested in an exhibit booth, check that option on this form. Several sponsorship opportunities are available for Power Up 2008. Information regarding sponsorship opportunities is attached. If your company is interested in any of those options, contact Missouri Assistive Technology. Early Registration -EXHIBIT BOOTH ($225) Company will donate a Door Prize EXHIBIT BOOTH ($250) –After Dec. 7, 2007 Presenter Sponsorship ($500 - $4000) Literature Display ($250) Monday Evening Reception ($1500) Tuesday Luncheon ($2500) Exhibit Hall Refreshment Break ($500) Print Advertisement Concurrent Session ($200) Contact Missouri Assistive Technology for more details on advertisement. Total Enclosed: $ NOTE to MO State Agencies: DO NOT process payment until you receive an InterAgency Billing (IAB) from Missouri Assistive Technology. Thank you. FORM must be received by December 7, 2007, to qualify for early registration discount. All forms and payment due by March 7, 2008. Make checks payable to Missouri Assistive Technology. Contact information: Brenda Whitlock Missouri Assistive Technology 4731 S. Cochise, Suite 114 Independence, MO 64055-6975 816-373-5193 (Voice) 816-373-9315 (TTY) 816-373-9314 (Fax) bwhitlck@swbell.net Power Up 2008 Expo Information Sheet Sponsor/Planner: Missouri Assistive Technology 4731 S. Cochise, Suite 114 Independence, MO 64055-6975 Telephone: (800) 647-8557 (V) (816) 373-5193 (V) (816) 373-9315 (TTY) Fax: (816) 373-9314 Web site: www.at.mo.gov E-mail: bwhitlck@swbell.net Location: Tan-Tar-A Resort State Road KK, P.O. Box 188 TT Osage Beach, MO 65065 Telephone: (573) 348-3131 Fax: (573) 348-8560 Web site: www.tan-tar-a.com Exhibit Booth: Includes one 8’ x 10’ booth, one 6’ draped table, two chairs, pipe and drape, wastebasket and identification sign, and two Exhibitor badges. Other Benefits: Free Admission to all Conference & Expo activities, including reception, meals, and keynotes. Your company will be listed in the Conference Booklet and on the Missouri Assistive Technology Power Up website. If registering early, your company will be listed in the conference brochure. Exhibitors receive an electronic listing of attendees to be used for educational purposes. Set-Up and Setup - Monday, April 21 between 8:00 a.m. and 1:00 p.m. Dismantling Dismantle – Tuesday, April 22 AFTER Noon. Times: Optional equipment (including electricity or phone line) must be ordered directly from the Tan-Tar-A Resort. Electricity will be free of charge to you, but must be ordered prior to March 7. Exhibit Times: Exhibits will be open to conference participants on Monday, April 21, 2008 from 2:00 p.m. to 7:00 p.m. and on Tuesday, April 22, 2008 from 7:30 a.m. to 12:30 p.m. A representative from your company must be present in the booth during the Expo Hall grand opening, the Monday evening reception, and during all breaks. Sales: Exhibitors are prohibited from selling items during the conference. You may take orders for later delivery. Registration: Mail Exhibit registration form and fee to Missouri Assistive Technology at the above address. Form must be received by December 7, 2007, to qualify for early registration discount. All forms and payment must be received by March 7, 2008. Written notification confirming receipt of your registration will be sent. Lodging: Call the Tan-Tar-A Resort to receive the discounted rate of $65, please mention that you are with the Missouri Assistive Technology/Power Up room block. Liability: Neither Missouri Assistive Technology nor Tan-Tar-A Resort shall be accountable or liable for any damage, loss, harm or injury to the person or property of the applicant or any of its officers, agents, employees, or other representatives, resulting from theft, fire, water, accident or other causes. The exhibit areas will be locked when not in use. Cancellation: Exhibitor registration fees will be deposited on March 7, 2008. There will be no refunds after that date. Power Up 2008 April 21 & 22, 2008 Tan-Tar-A Resort Osage Beach, Missouri SPONSORSHIP OPPORTUNITIES Several Power Up 2008 sponsorship opportunities are described below. If your company is interested in one or more of the opportunities described below, please contact Missouri Assistive Technology. CONCURRENT SESSION ($250) Sponsorship benefits: Your company’s signage at meeting room entrance and at speaker’s table/podium If exhibiting, signage at your table Your company’s name announced during the session Recognition of your company in the Conference Booklet Recognition of your company on Missouri Assistive Technology website Your company will be allowed to provide promotional items (i.e. note pads, pencils, etc. with your logo) to course participants PRESENTER SPONSORSHIP (VARIED, $500 TO $5000) Sponsorship Benefits: At least one complimentary registration and other benefits commensurate with sponsorship amount Company named in promotionals & advertising EXHIBIT HALL REFRESHMENT BREAK ($500) Sponsorship benefits: Your company’s signage by the refreshments One complimentary conference registration If exhibiting, signage for your table Your company’s name announced in the opening as a sponsor Recognition of your company in the Conference Booklet Recognition of your company on MoAT website Recognition of your company on large conference signage MONDAY EVENING RECEPTION ($1500) Sponsorship benefits: Two complimentary conference registrations If exhibiting, signage for your booth Your company’s name announced in the opening as a sponsor Your company’s signage by the Reception Recognition of your company at the Reception Recognition of your company in the Conference Booklet Recognition of your company on MoAT website Recognition of your company on large conference signage TUESDAY LUNCHEON ($2500) Sponsorship benefits: Four complimentary conference registrations If exhibiting, signage for your table and special recognition for badge Six (6) complimentary luncheon tickets for members of your company Your company’s name announced in the opening as a sponsor Your company’s signage at entrance of the luncheon ballroom Recognition of your company during the luncheon Recognition of your company in the Conference Booklet Recognition of your company on MoAT website Recognition of your company on large conference signage PRINT ADVERTISEMENT - Contact Missouri Assistive Technology for details