17th Annual FICAP Convention

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17^th Annual Convention Sponsor Registration Form

July 14 – 16, 2011

Company Name: Contact:

Mailing Address:

City: State: Zip:

Phone: Email:

A special thank you to the following sponsors:

Banquet Entertainment Sponsor: Fishing Tournament Sponsor:

Sponsorships Available –

All sponsors will be recognized during Saturday evening’s banquet, on the FICAP website, the eNews publication, and within the convention program. Additionally, each sponsorship listed below will include a sign and acknowledgement at the specified event.

Calcutta Auction/Reception - Platinum Sponsor $1000.00Calcutta Auction/Reception - Silver Sponsor $500.00"Concretians" Sponsor $350.00

Producer Dinner                                        $500.00               Volleyball Tournament                          $200.00
Breakfast                                                      $400.00
Break                                                              $200.00

All sponsorship information must be received by July 1, 2011.

Total: $

Method of Payment: Once you submit this page, you will have the option of paying on line, or mailing in a check. Please select which method you plan on using: On Line Mail a Check

Please make sure you enter in the correct pricing including the total, then press "Submit".