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EXECUTIVE SPONSORSHIP REGISTRATION

Contact Name: *

First

Last

Contact Email Address: *

Name of Sponsoring Company/Organization: *

Company Phone: *

Cell Phone: *

Address: *

City / State / Zip Code: *

Country:

An EXECUTIVE Sponsorship is $12,500. Select Your Preferred Payment Option: *

You may either pay in full today, or pay 50% (the remaining 50% will be billed to you by Dec. 1.)

ERA would like to use your company logo for Conference marketing purposes and to highlight your company as a sponsor. Please check the option below that applies to your company logo. *

Please use the same logo you have on file, that has been used in previous years.
My company is a NEW sponsor and will be submitting a new logo.
My company has sponsored before, but I will be submitting a new or updated logo.

If you are submitting a new company logo (see the above question), please upload it below in PNG or JPG form:

Drag & Drop Files, Choose Files to Upload

An EXECUTIVE Sponsorship allows your company 6 complimentary Conference registrations. Please list your 6 attendees below. (If you don’t know all of the attendee names yet, please put “TBA” for the names not known.)

ATTENDEE 1 – Full Name: *

First

Last

ATTENDEE 1 – Email Address: *

ATTENDEE 1 – Phone: *

ATTENDEE 1 – Title/Role: *

ATTENDEE 1 – Estimated # of Years in Industry: *

ATTENDEE 2 – Full Name:

First

Last

ATTENDEE 2 – Email Address:

ATTENDEE 2 – Phone Number:

ATTENDEE 2 – Title/Role:

ATTENDEE 2 – Estimated # of Years in Industry:

ATTENDEE 3 – Full Name:

First

Last

ATTENDEE 3 – Email Address:

ATTENDEE 3 – Title/Role:

ATTENDEE 3 – Estimated # of Years in Industry:

ATTENDEE 4 – Full Name:

First

Last

ATTENDEE 4 – Email Address:

ATTENDEE 4 – Phone Number:

ATTENDEE 4 – Title/Role:

ATTENDEE 4 – Estimated # of Years in Industry:

ATTENDEE 5 – Full Name:

First

Last

ATTENDEE 5 – Email Address:

ATTENDEE 5 – Phone Number:

ATTENDEE 5 – Title/Role:

ATTENDEE 5 – Estimated # of Years in Industry:

ATTENDEE 6 – Full Name:

First

Last

ATTENDEE 6 – Email Address:

ATTENDEE 6 – Phone Number:

ATTENDEE 6 – Title/Role:

ATTENDEE 6 – Estimated # of Years in Industry:

Total

$0.00

Credit Card *

Card

Name on Card

Please note: The main contact email address given above will receive an electronic receipt. Check your spam folder if you are unable to locate the receipt in your inbox.

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