AC2014 Sponsor Application

Contact Information
Company Name
Company Contact Name
City State Zip
Description of Company: Please limit to 50 words.
Level of Sponsorship:
(check one)
Platinum ($5,000)
Gold ($3,500)
Silver ($2,000)
Bronze ($1,000)
Buckeye ($500)
Morning/Afternoon Break or Breakfast Sponsor ($1,000)
Exhibitor Details (check one):
Check here if you have completed your Exhibitor Application (deadline is August 1, 2014)
Check here if you do NOT wish to Exhibit.
Publicity Details:
Check here if you have e-mailed your company’s high resolution logo (300dpi) (.ai. .psd, .png or .jpg format only) to
In order for Midwest Center to guarantee inclusion in conference program materials, the completed form and payment must be received by August 1, 2014.
   - denotes required fields