Forum 2012

Sponsorship Registration Form

FAX your completed form today!

Send to 1.202.729.6756
INFORMATION

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Last Name _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _
As you wish to appear on your name tag at the forum

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Non-member non-profit
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Government
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Registration confirmation will be sent via email

BE A SPONSOR AT THE INTERACTION FORUM

Corporate/Government Non-Member/Non-Profit InterAction Member
Diamond ($100,000)
Diamond ($90,000)
Diamond ($80,000)
Platinum ($75,000)
Platinum ($60,000)
Platinum ($50,000)
Gold ($50,000)
Gold ($40,000)
Gold ($30,000)
Silver ($25,000)
Silver ($20,000)
Silver ($15,000)
Bronze ($15,000)
Bronze ($10,000)
Bronze ($5,000)
InterActions Scholarship Fund
As a new sponsorship feature this year, we will be offering each
sponsoring organization an opportunity to designate 10% of their
sponsorship for InterActions Scholarship Fund, which covers fees for
young professionals with career interest in international development and
to individuals from the global south to attend the InterAction Forum.
Please indicate your preference for booth location/table top location:

1st_____________2nd_____________3rd_____________

ADVERTISING OPPORTUNITIES
Advertise in the Forum 2011 Program

1/4 Page ($500)

1/2 Page ($750)
Full Page ($1000)

Advertise in Monday Developments

1/4 Page ($915)

1/3 Page ($1090)
1/2 Page ($1315)
Full Page ($2175)

Note: Complimentary advertising space in Julys Forum-recap issue of

Monthly Developments is included in some sponsorship packages, but
sponsors may also wish to purchase additional advertising in the May issue
that will be distributed at the Forum itself. A discount is offered if you choose
to run in multiple issues of Monthly Developments throughout the year.

MEALS & FUNCTIONS

The following meals are includued in your complete forum registration.

Monday, April 30

Tuesday, May 1

Wednesday, May 2

Networking Luncheon
Plenary Breakfast
Exhibit Hours Breakfast
Exhibit/Happy Hour
Plenary Luncheon
Closing Plenary Luncheon

Gala Reception

Gala Dinner
SPECIAL ACCOMMODATIONS

I prefer vegetarian meals
I have special needs as follows:

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Exhibitor registration deadline is April 13.

Cancellations must be submitted by e-mail
to forum@interaction.org by April 16.

Need extra tickets?

GALA PLENARY & AWARDS BANQUET

Full Table (9 Additional seats for $800)

Additional Seat
Tickets are $100 each. How many? ____
TOTAL $ ___________

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ADDITIONAL
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FULL CONFERENCE Title
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REGISTRATION

BOOTH PERSONNEL PASSES

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First Name _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _
Last Name _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _

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There will be $20 charge for each additional booth personnel. Please include in your total payment.

PAYMENT INFORMATION

VISA Master Card American Express

Card Holders Name _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _

Credit Card Number _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _ | _

Expiration Date ____/____/______
Card Holders Signature ________________________
Date
____/____/______

Make checks payable to InterAction

Be sure to write EXHIBITOR PROGRAM in the memo field. Send payments to:

InterAction, Attn: Forum Registrar

1400 16th Street, NW, Suite 210
Washington, DC 20036 USA
Tel: 1.202.667.8227