NC Providers Council and the College of Direct Support

NEW!  The NC Providers Council has added a five-level STAR Sponsorship opportunity that meets the budget of small and large companies while offering superior value and maximum exposure during our conference. 

North Carolina Providers Council Exhibit/Sponsorship Registration Form                             October 6-7  2009 Accepting the Leadership Challenge ….   Sponsorship Opportunities: Check all that apply ____ 5-Star Sponsor Level for $2,750 (limit 5)             Includes 1 year Provider Support Membership Dues* ____ 4-Star Sponsor Level for $2,250                 Includes 1 year Provider Support Membership Dues* ____ 3-Star Sponsor Level for $1,000 ____ 2-Star Sponsor Level for $750 ____ 1-Star Sponsor Level for $500 ____ I wish to exhibit as a Non-member for $425 ____ I wish to exhibit as a member for $325 ____ I will need electricity and have included an additional $40 ____ *I have included my Provider Support membership application with my sponsorship package Payment Options:    [  ]Check/Cash  [   ] MasterCard/Visa  [   ] Discover  Cardholders Name: ______________________________________________Amount:___________________ Card #: ________________________________________________________**Exp. Date:________________ Billing Address w/zip code of card:____________________________________________________________ Check #: _______________________Amount:_________________________ (Make check payable to NC Providers Council)             EASY ways to reserve your space: aRegister on-line via our website aCall  919-784-0230 aFax with Credit Card to 919-784-0231 aEmail PDF of form using a credit card to: diana.mills@ncproviderscouncil.org aMail: NC Providers Council                 Attn: Diana Mills                 4700 Homewood Court, Ste. 320                 Raleigh, NC  27609                Sheraton Greensboro at Four Seasons 2009 Annual Conference