Exhibitor Registration 6500 Busch Boulevard Suite 100Columbus, Ohio

USA43229-1758

Phone: 614 221 0707Fax: 614 221 5761

http://ogrip.oit.ohio.gov/Events/OhioGISConference.aspx

2011 Ohio GIS Conference : Hyatt Regency Columbus, September 29 and 30 350 North High Street, Columbus, Ohio, USA 43215 Tel: +1 614 463 1234 Fax: +1 614 280 3034 http://www.columbusregency.hyatt.com Hotel Reservations: https://resweb.passkey.com/go/GIS2012 Note: Reserve by 8/31/12 to ensure a sleeping room and special conference room rate.

September 20, 2012 Set-Up: 6:00 am - 8:00 am  Open: 8:00 am - 6:00 pm

September 21, 2012 Open: 7:30 am - 12:30 pm Disassemble: 12:30 pm - 2:00 pm

Attendee Information

Name:

Name (2):

Name (3):

Name (4):

Company:

Address:

State/Province:

Zip/Postal Code:

Country:

Main Contact:

Email:

Phone:

Title:

Title:

Title:

Title:

Note: Exhibitor Fee includes 2 full registrations which include 2 lunches on Friday. Any additional staff working the booth must either pay full registration costs if attending the conference workshops and/or sessions. Additional staff may staff the booth and pay for additional meals separately.

Registration Fees

Number of Extra Meals

*Total Due (Meals+Exhibit Fee):

x $30 =

Registration Fee $

* Please use another form if more than 4 registrations are needed.

Payment

Purchase Order

Check (Payable to CEAO)

Mail this form completed to: County Engineers Association of Ohio 6500 Busch Boulevard Suite 100 Columbus, Ohio 43229-1758 OR e-mail (if Applicable): dbickers@ceao.org

PO Number

Send Invoice

Use the diagram on the second page to fill out your preferences of booth selection.

1st Choice 2nd Choice

3rd Choice

Note: Booth assignments based on preferences are not guaranteed and are at the discretion of the Conference Planning Committee. We will try to adjust everyone as best as possible.

Please describe your products and services, any special needs and list any exhibitors you wish to be located away from.

Attention: Neither CEAO, Ohio URISA or OGRIP nor any other sponsors for the Conference can be held responsible for damaged, lost, or stolen equipment.

If Not Registering On-Line ThenMail, e-mail or Fax This Form

City:

*The Ohio Chapter of URISA is providing a 2013 membership for each registered attendee. Opting out of the Ohio Chapter of URISA membership will not affect the conference registration cost. Information regarding the benifits of the Ohio Chapter of URISA membership can be found at: http://ohurisa.org/ I do not want to be an member or Receive Ohio URISA Benefits.*

Sponsorship Form CEAO6500 Busch Boulevard Suite 100

Columbus, OhioUSA

43229-1758Phone: 614 221 0707

Fax: 614 221 5761

http://ogrip.oit.ohio.gov/Events/OhioGISConference.aspx

Conference Location: Hyatt Regency Columbus 350 North High Street, Columbus, Ohio, USA 43215 Tel: +1 614 463 1234 Fax: +1 614 280 3034 http://www.columbusregency.hyatt.com Hotel Reservations: https://resweb.passkey.com/go/GIS2012 Note: Reserve by 8/31/12 to ensure a sleeping room and special conference room rate.

Conference Dates: September 20th and 21st Preconference Workshops Date: September 19th

Sponsor Attendee Information

Name:

Address:

State/Province:

Zip/Postal Code:

Country:

Main Contact:

Email:

Phone:

Title:

Bronze (Vendor): $250

Silver (Vendor): $500

Gold: $1000

Platinum: $1500

Payment

Purchase Order

Check (Payable to CEAO)

Mail this form completed to: County Engineers Association of Ohio 6500 Busch Boulevard Suite 100 Columbus, Ohio 43229-1758 OR e-mail (if Applicable): dbickers@ceao.org

PO Number

Send Invoice

· Slide recognition of firm at opening session · 1-page flyer insert provided by Vendor in attendee

packet · Recognition (signage) at Map Gallery, all breaks and

Friday lunch · Recognition (signage) at Thursday night event · Additional marketing material in the attendee packet

(i.e. pen, magnet, mouse pad, etc.)

· Slide recognition of firm at opening session · 1-page flyer insert provided by Vendor in attendee

packet · Recognition (signage) at Map Gallery, all breaks and

Friday lunch · Recognition (signage) at Thursday night event

· Slide recognition of firm at opening session · 1-page flyer insert provided by Vendor in attendee

packet · Recognition (signage) at Map Gallery, all breaks and

Friday lunch

· Slide recognition of firm at opening session · 1-page flyer insert provided by Vendor in attendee

packet

If Not Registering On-Line ThenMail, e-mail or Fax This Form

City: