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2010 WBC Sponsor/Exhibitor Registration Form

Sponsor/Exhibitor Registration Form
Western Benefits Conference
The Best of Both Worlds • July 18 - July 20, 2010
JW Marriott LA Live | Los Angeles, CA

Step One - Registrant Information

Please register only one person per form. Complete all applicable steps and click 'Submit' at the bottom of this form to complete your registration. Steps one and three are mandatory sections.

First Name:   MI:    Last Name:
Name for Badge:  Designations:
Title:
Company:
Address:
City:   State:    Zip:
Phone:   Fax:
E-mail:

Please note that the information printed above for Badge Name, Company, City and State will appear on your conference badge exactly as stated.

Is this person designated as the on-site contact?

If the address above is different from the mailing label, does this signify a change of address to be updated in the participant record?

Step Two - Additional Information

Please check dietary requirements (if applicable):
    

If you require special accommodations due to a disability, please specify: 

Step Three - Registration Type

Please select applicable registration below. With your event sponsorship or exhibit space you receive a certain number of complimentary registrations and are limited to purchasing two additional registrations (either two Full Conference*, or two Booth-only*, or a combination of the two). Please refer to the information below when making your selection from the drop down list.

Sponsorship Level:
Platinum - Four Full Conference Registrations                      Gold - Three Full Conference Registrations
Silver - Two Full Conference Registrations                            Bronze - Two Full Conference Registrations
Exhibitor-Only - Two Full Conference Registrations

Complimentary Full  Conference (Included with sponsorship or booth) $0
Full Conference $710
Booth-Only $575

GUEST TICKETS
One Guest Ticket Monday Lunch $50
One Guest Ticket Tuesday Lunch $50

* Full conference registration entitles you to attend sessions, receive a conference tote bag, and have full access to the Exhibit Hall. Booth-only registration does not include a conference tote bag or access to sessions, only full access to the Exhibit Hall.

** To qualify for the Member rate, you must be a member of either WP&BC or ASPPA.

Step Four - Payment

Credit card:               

   

Please submit this form with credit card information by clicking the Submit Button below. If you wish to print and submit this form by e-mail or fax please send to mlipanovich@asppa.org or 703-516-9308.

Payment by check may delay processing of this registration by up to two weeks. It is advised to submit your registration with credit card payment. Payments by check must be accompanied by this form and submitted to: ASPPA, P.O. Box 34725, Alexandria, VA  22334

Step Five - Session Selections - FULL CONFERENCE REGISTRANTS ONLY

Sunday, JULY 18
4:00 p.m. - 5:15 p.m.





Monday, JULY 19
8:30 a.m. - 9:45 a.m.






10:15 a.m. - 11:30 a.m.

Session 12: Auto Enrollment

1:45 p.m. - 3:00 p.m.





3:30 p.m. - 4:45 p.m.





Tuesday, JULY 20
8:30 a.m. - 9:45 a.m.






10:15 a.m. - 11:30 a.m.


e

1:45 p.m. - 3:00 p.m.





3:30 p.m. - 4:45 p.m.




       

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