Exhibitor Sponsorship Order Form

Bill Me Later:

Billing Information (* All fields are required)

Please check here if same as above.

First Name:

Last Name:

Business Title:

Company:

Address:

City:

State/Province:

Zip/Postal Code:

Country:

Email Address:

Telephone:

Credit Card Information

Credit Card Type:

Credit Card Number:

(do not enter dashes or spaces)

Credit Card CSC:

(3 or 4 digit number on the back of your card)

Expires:

/

Name: (as it appears on card)

CONTACT INFORMATION
*First Name
*Last Name
*Job Title
*Exhibiting Company Name
*Telephone
*Email Address

SPONSORSHIP LEVELS
Select sponsorship level:	Platinum Sponsor - $10,000.00 Gold Sponsor - $7,500.00 Silver Sponsor - $5,000.00
MARKETING OPTIONS
Online Exhibitor Profile Enhanced Upgrade	Included in the Platinum, Gold and Silver Sponsorship Packages - $450.00
*Upload your 72 dpi logo in eps, jpg or png format*
Post-Show Attendee Email	Limit 4 - $2,500.00
Choose preferred email send date: Order Deadline: 9/1/22 File Deadline: 9/15/22	October 18, 2022 October 24, 2022 November 1, 2022 November 7, 2022
In-Booth Video Interviews	Limit: 15 - $5,000.00
Communication Agreement: I agree that by submitting this form I may receive communications from the Association for Advancing Automation (A3) regarding this and other association activities. A3 respects data privacy as outlined in our Privacy Policy.
*Please select agreement	Yes No

CONTACT INFORMATION