2023 Conference Registration 2023 Conference Registration You may use this form to sign up to attend the 2023 WAPA conference, to secure exhibitor space (which includes two complimentary attendees), and to sponsor the event. "*" indicates required fields Unique IDMember Type*Please SelectWAPA MemberGovernment/EducationNon-WAPA MemberRegister to AttendWould you like to register to attend?* Yes No Please select a Member Type above.Attendees Attendee Name Actions Edit Delete Please click the button below to add attendees. Add attendee Maximum number of attendees reached. HiddenNumber of AttendeesHiddenMember RateHiddenGov/Ed RateHiddenNon-Member RateAttendees Total Price: $0.00 Exhibit at the ConferenceWould you like to exhibit at the conference? Yes No As an exhibitor you will receive: A booth in our exhibitor space Conference registration for up to two individuals Recognition in the conference program as an exhibitor A business card-sized ad in the conference program (See the ad specifications) A tabletop and electrical outlet are provided to each exhibitor. Exhibitor spaces are preassigned, with requests granted on a first-come, first-served basis upon receipt of payment.Please select a Member Type above.Exhibitor Rate Price: Please list up to two complimentary attendees here included with your Exhibitor fee. DO NOT include these names in the regular Attendee section above or you will be charged twice for these attendees.Complimentary Attendees Attendee Name Actions Edit Delete Please click the button below to add attendees. Add Complimentary Attendee Maximum number of complimentary attendees reached. Sponsor the ConferenceWould you like to sponsor the conference?* Yes No As a sponsor you will receive: Recognition in the conference program at your sponsorship level Your company logo on signage or projected display (throughout the conference for full sponsors or at your specific sponsored event) Recognition as a sponsor by the conference emcee during the conference (throughout the conference for full sponsors or at your specific sponsored event) Gold, Silver and Bronze sponsors also receive a business card-sized ad in the conference program (see the ad specifications) Full Conference SponsorshipsFull Conference Sponsorships Gold Silver Bronze Event SponsorshipsEvent Sponsorships Awards and Scholarship Luncheon (Day 1) Beverage/Snacks (Day 1) Beverage/Snacks (Day 2) Cocktail Hour (sold out) Dinner Hospitality Room Breakfast Billing ContactName* First Last Company/Organization* Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code TotalsPayment {all_fields}How would you like to pay? Credit Card Send me an invoice Δ
