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O'IIC.'IID 3,000 <br />*Company logo displayed throughout the <br />conference on signage <br />* Company name on the lighted kiosk in the <br />registration area <br />* Company name listed in the final program <br />mailer and on-site program directory <br />* Company logo displayed on PowerPoint <br />presentations at select event functions, including <br />Member -Hosted Reception and meal functions <br />A- Gold Sponsor ribbon <br />S111LIVEIR .....$1,500 <br />* Company name on the lighted kiosk in the <br />registration area <br />* Company name listed in the final program <br />mailer and on-site program directory <br />* Company logo displayed on PowerPoint <br />presentations at select event functions, including <br />Member -Hosted Reception and meal functions <br />A- Silver Sponsor ribbon <br />lRONIZ1E $500 <br />* Company name on the lighted kiosk in the <br />registration area <br />* Company logo displayed on the PowerPoint <br />presentation at the Member -Hosted Reception <br />* Bronze Sponsor ribbon <br />DEADLINE <br />SPONSOR CONTACT <br />RETURN COMPLETED FORM <br />ICSC CONTACT <br />Sponsorship must be received no <br />Shawn Ackerman <br />AND PAYMENT TO: <br />Christabelle Flanhardt <br />later than October 4, 2013 to be <br />Henry S. Miller Brokerage, LLC <br />ICSC <br />Tel: +1646 728 3638 <br />Tel: +1713 626 2828 <br />P.O. Box 26958 <br />E-mail: cflanhardt@icsc.org <br />recognized at the conference. <br />E-mail: shawnackerman@ <br />New York, NY 10087-6958 <br />henrysmiller.com <br />Fax: +1732 694 1800 <br />(credit card payments only) <br />Name <br />Company <br />Address <br />City State/Province Zip/Postal Code <br />Telephone Fax <br />E-mail Your ICSC Membership I.D.# <br />Please check here if any of the above information has recently changed. <br />Method of payment <br />❑ Check made payable to ICSC enclosed for $ <br />❑ MasterCard ❑ Visa ❑ AMEX ❑ Discover <br />Name (as it appears on credit card) <br />Signature <br />IN <br />Credit Card Number (include all digits) <br />Expiration Date (month/year) <br />2013TX-S <br />