Select the Event * ( Required )
Brevard Co./Melbourne, FL Broward , FL Central FL (Sumter, Lake, Marion, Alachua), FL Charlotte, NC Chatham County, GA Cincinnati, OH Cleveland, OH Cobb County, GA Columbia, SC Columbus, OH DeKalb + Fulton Counties, GA Detroit, MI Grand Rapids, MI Greenville, SC Hillsborough/Tampa BREAKFAST, FL Jacksonville, FL Lansing, MI Miami, FL Naples (Collier), FL Newport News, VA Norfolk, VA Orlando, FL Palm Beach, FL Pasco (Pasco, Hernando), FL Pinellas-Lower County/BREAKFAST, FL Pinellas-Upper County, FL Richmond, VA Roanoke/BREAKFAST, VA Sarasota (Sarasota, Manatee), FL Southwest FL (Charlotte, Lee), FL Treasure Coast (Martin, St. Lucie, Indian River), FL Triangle-Raleigh/Durham, NC Winston-Salem, NC
Business Name * ( Required )
Participation Levels:
Bronze Sponsorship ($300) (formerly ADOPT A TABLE) Includes one lunch
Silver Sponsorship ($750) Includes one lunch
Any extra lunches not included with sponsorship $60
If you are bringing a SW or CM, they must register separately on the home page
Gold Sponsorship ($850) Includes two lunches
Platinum Sponsorship ($950) Includes two lunches
Diamond Sponsorship ($1350) Includes four lunches
Corporate Sponsorship ($8500) for 10 events in Florida
Corporate Sponsorship ($12000) for all 15 events in Florida
* List the names of those attending the Event below:
List the name of those attending below. The main contact should be listed FIRST. (Cell numbers will only be used for emergencies and confirmations, this number will NOT be shared to anyone)
Attendee*
Level*
Last Name*
First Name*
Title*
Email*
Cell#*
#1
Level
Extra Attendee
Bronze/Formerly Adopt a table Sponsor
Silver Sponsor
Gold Sponsor
Platinum Sponsor
Diamond Sponsor
Corporate Sponsor
#2
Level
Extra Attendee
Bronze/Formerly Adopt a table Sponsor
Silver Sponsor
Gold Sponsor
Platinum Sponsor
Diamond Sponsor
Corporate Sponsor
#3
Level
Extra Attendee
Bronze/Formerly Adopt a table Sponsor
Silver Sponsor
Gold Sponsor
Platinum Sponsor
Diamond Sponsor
Corporate Sponsor
#4
Level
Extra Attendee
Bronze/Formerly Adopt a table Sponsor
Silver Sponsor
Gold Sponsor
Platinum Sponsor
Diamond Sponsor
Corporate Sponsor
#5
Level
Extra Attendee
Bronze/Formerly Adopt a table Sponsor
Silver Sponsor
Gold Sponsor
Platinum Sponsor
Diamond Sponsor
Corporate Sponsor
For security reasons type in the correct answer: * ( Required )
Brevard Co./Melbourne
Broward
Central FL (Sumter, Lake, Marion, Alachua)
Charlotte
Chatham County
Cincinnati
Cleveland
Cobb County
Columbia
Columbus
DeKalb + Fulton Counties
Detroit, MI
Grand Rapids, MI
Greenville
Hillsborough/Tampa BREAKFAST
Jacksonville
Lansing, MI
Miami
Naples (Collier)
Newport News
Norfolk
Orlando
Palm Beach
Pasco (Pasco, Hernando)
Pinellas-Lower County/BREAKFAST
Pinellas-Upper County
Richmond
Roanoke/BREAKFAST
Sarasota (Sarasota, Manatee)
Southwest FL (Charlotte, Lee)
Treasure Coast (Martin, St. Lucie, Indian River)
Triangle-Raleigh/Durham
Winston-Salem
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