(HT) Facilities 2014 Applications - 01/15/14

2014 BASA School Facilities Conference Presenter Application March 12-13, 2014 Doubletree Hotel-Worthington, 175 Hutchinson Avenue Columbus, OH 43235 **DEADLINE FOR SUBMISSION: January 15, 2014**

Presenter Qualifications Preference will be given to Partners or Members. If you would like information on becoming a BASA Partner, contact Kathy Lowery at lowery@basa-ohio.org or by phone at 614-846-4080. Session Purpose Presentation sessions are intended to provide information to audience members. They are not for sales presentations or product endorsement. Session Selection All applications will be reviewed by BASA. You will be notified within 30 days of receipt of your application if your session topic has been selected. There is no limit to the number of applications submitted or topics selected. Selection is based on relevance of the topic and to avoid regarding the presentation application, please contact Kathy Lowery at lowery@basa-ohio.org or by phone at 614-846-4080. Please fax or mail your completed application no later than January 15, 2014 to: BASA 8050 N. High Street, Suite 150 Columbus, OH 43235 Fax: 614-846-4081 duplication. Questions? If you have questions

Speaker’s Name: Speaker’sTitle: Presentation Title: Firm/School District: Address:

City, State, ZIP: Email Address:

/_

Contact Person/Title:

-_ _-

-_ _-

Phone #:

Fax:

Email:

Presentation Format: (Please check one) □ Presentation: Theatre seating, podium, microphone, PowerPoint or overhead presentation □ Panel Discussion: Up to four (4) panel members with open participation from audience members □ Other :

Please provide a description of your session in 2 to 4 sentences (MAX) . Include what the participant will learn and how the knowledge will benefit them.

AV Equipment: Please note that if you will require a laptop and/or projector for your presentation, it is your responsibility to bring those items with you . BASA will not be able to provide that equipment for you.

**Exhibit Spaces are VERY Limited!** **Deadline for returning Exhibitor Application: January 15, 2014** PLEASE FAX COMPLETED FORM TO BASA at 614-846-4081 2014 BASA School Facilities Conference Exhibitor Application March 12 & 13, 2014 Doubletree Hotel-Worthington, 175 Hutchinson Avenue, Columbus OH 43235 Phone: 614-885-3334 Fax: 614-846-4353

Company/Organization: ___________________________________________________________ Contact Name and Title: ___________________________________________________________ Address: _________________________________________________________________________ City, State, ZIP: ___________________________________________________________________ Phone Number: ____________________________ Fax: ____________________________________ Email: ___________________________________________________________________________ NAMES & TITLES (WE MUST HAVE TITLES) of those hosting your booth (for name tag purposes) : 3. ___________________________________ 4. ________________________________________ Booth Cost:  BASA Partners: $500.00  Non-Partners: $1,000.00 Booth Information: Your booth will include 1 table with 2 chairs. Carpet is not needed. If you require electricity, please check the box below. You will be notified of your booth’s placement by February 28, 2014. Pop-Up Size: Height______ Width_____ Table Size:  6 foot  8 foot Do you wish for BASA to supply the table for your exhibit?  Yes  No Electricity Needed?  Yes  No Meal Tickets: Each exhibitor will receive 2 complimentary meal tickets for Continental Breakfasts & Lunch. Additional meal tickets may be purchased at a cost of $30.00 per person. Please provide ____ additional meal tickets. Total Cost: $_________________________ Payment Information:  I have enclosed my check for $_________ 1. ___________________________________ 2. ________________________________________

(Please make checks payable to Buckeye Association of School Administrators)  I would like to be invoiced by BASA (Note: Payment is due within 30 days of invoice)

PLEASE FAX COMPLETED FORM TO BASA at 614-846-4081 NO LATER THAN JANUARY 15, 2014 2014 BASA School Facilities Conference Sponsorship/Door Prize Contract March 12 & 13, 2014 Doubletree Hotel-Worthington

Company/Organization ___________________________________________________________ Contact Name and Title ________________________________________________________________ Address ______________________________________________________________________________ City, State, Zip ________________________________________________________________________ Phone Number____________________________Fax_________________________________________ Email ________________________________________________________________________________ If you wish to have name badges made for the conference, please give names and titles (WE MUST HAVE TITLES) below. (If you are already hosting an exhibit booth, there is no need to give this information again.) 1.___________________________________ 2.___________________________________ 3.___________________________________ 4.___________________________________ Sponsorship Options:

□ $2,500 Full Sponsorship □ $2,500 Full Sponsorship □ $1,500 Full Sponsorship □ $1,500 Full Sponsorship

□ $1,250 Co-Sponsorship □ $1,250 Co-Sponsorship □ $750 Co-Sponsorship □ $750 Co-Sponsorship

Breakfast: Wednesday, March 12 Breakfast: Thursday, March 13

Morning Break: Wednesday, March 12 Morning Break: Thursday, March 13

□ $3,500 Full Sponsorship

□ $1,750 Co-Sponsorship

Lunch: Wednesday, March 12

□ $1,500 Full Sponsorship □ $5,000 Full Sponsorship

□ $750 Co-Sponsorship □ $2,500 Co-Sponsorship

Afternoon Break: Wednesday, March 12

Reception: Wednesday, March 12

Donation Options: My company would like to donate the following item(s) to be used for the door prize drawing at the 2014 BASA School Facilities Conference . I understand that my company will be recognized during the drawing for the donation. _____________________________________________________________________________________________

_________________________________ Company Representative Name

_______________________________ Company Representative Signature