SPONSORSHIP LEVELS

DIAMOND SPONSOR: Over $5,000 Five free conference registrations, including meals Plaque of appreciation Organizations name on conference materials and media contacts
What can we do with $5,000? Pay speaker fee and travel expenses for two keynote presenters. Provide full scholarships, including travel expenses, for 10 attendees.

PLATINUM SPONSOR: $3,500 - $5,000 Four free conference registrations, including meals Plaque of appreciation
Organizations name on conference materials and media contacts
Pay for one days breakfast, lunch, and break refreshments Provide registration fee waivers to 20 attendees. What can we do with $3,500?

GOLD SPONSOR: $1,500 - $3,499 Three free conference registrations, including meals Plaque of appreciation Organizations name on conference materials and media contacts
What can we do with $1,500? Provide flash drives to attendees with all conference materials. Provide travel scholarships for five attendees.

SILVER SPONSOR: $750 - $1,499 Two free conference registrations, including meals Certificate of appreciation Organizations name on conference materials and media contacts
What we can do with $750? Provide continuing education credits for entire conference. Pay speaker fees for two workshops.

BRONZE SPONSOR: $250 - $749 One free conference registration, including meals Certificate of appreciation Organizations name on conference materials and media contacts
What can we do with $250? Provide coffee breaks for one day. Provide registration fee scholarships for two attendees.

SPONSORSHIP AGREEMENT
(Agency Name) _________________________________________ will provide sponsorship at the Diamond Platinum Gold Silver Bronze level for Louisianas 9th Annual Statewide Conference on Sexual Assault and Family Violence. This sponsorship will be in the form of:

Funding in the amount of $________ In- kind donation of ______________________________________________________.

My agency

will will not

require exhibit space. Exhibit Form is attached.

Agency Authorized Representative: ________________________________________________________________________ Print Name Clearly Signature ________________________________________________________________________ Address City State Zip ________________________________________________________________________ Phone Fax Email Please fax, mail, or email all forms to: Mariah Stidham Wineski LAFASA 1250 S W Railroad Ave., Ste. 170 Hammond, LA 70403 Fax: 985-345-5592 Mariah@lafasa.org

REQUEST FOR EXHIBIT SPACE

CONTACT NAME ORGANIZATION/COMPANY NAME MAILING ADDRESS CITY PHONE FAX STATE EMAIL ZIP ______ ______

I am interested in exhibit space for the upcoming 9th Annual Statewide Conference on Sexual Assault and Family Violence, being held at the Baton Rouge Marriott, November 27-29, 2012. Space is limited and is available on a first come, first served basis. Booths may be set up starting at 8:00 a.m. on Tuesday, November 27th. The cost of exhibit space is as follows: Conference Sponsor (no charge) Non-profit agencies - $100 For-profits - $250 TOTAL REMITTED $ Payment by: ___ check or money order payable to LAFASA ___ charge the exhibit fee to my Visa, Mastercard or Discover: Card Name: ______________________________________________________________ Acct. #_________________________________________ Exp. Date ________________ I intend to sell exhibit the following items:

Signature MAIL COMPLETED FORM WITH PAYMENT TO: Mariah Stidham Wineski LAFASA Director of Education 1250 SW Railroad Ave., Ste. 170, Hammond, LA 70403 Phone 985-345-5995 * Fax 985-345-5592 * Mariah@lafasa.org

Date