Corporate Sponsorship (Select level below) Choose One Title Sponsor - $50,000 Presenting Sponsor - $40,000 Platinum Sponsor - $30,000 Gold Sponsor - $20,000 Silver Sponsor - $10,000 Ticket Sponsor - $5,000 Bronze Sponsor - $5,000 Corporate Exhibitor Only - $2,500 Honorary Donations (non-exhibitor) $4,000 Honorary Donations (non-exhibitor) $3,000 Honorary Donations (non-exhibitor) $2,000 Honorary Donations (non-exhibitor) $1,000 Non-Profit Association same as Exibitor schedule Exhibitor

Non-Profit Association (must document 501c3 status) - $400
Exhibitor Early Bird Special $400
(Thru July 31, 2011)
Exhibitor - $550
(Aug. 1 thru Nov. 1, 2011)
Exhibitor - $650
(Nov. 2 thru Dec. 9, 2011)

The Carol Brandon Breast Cancer Prevention Fund Choose One Honor Sponsor - $25 Buddy Sponsor - $45 Mammogram Sponsor - $90 Supporter Sponsor - $100 Business Sponsor - $250 Corporate Exhibitor Only - $2,500 Executive Sponsor $500 Other (fill in amount)
Other Amount:
Yes, Sign me up for Kwanzaafest 2011!
No, although here is my donation of $

Personal Information

1. First Name:
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5. City:
6. State: Choose One ALABAMA (AL) ALASKA (AK) ARIZONA (AZ) ARKANSAS (AR) CALIFORNIA (CA) COLORADO (CO) CONNECTICUT (CT) DELAWARE (DE) DIST. OF COLUMBIA (DC) FLORIDA (FL) GEORGIA (GA) HAWAII (HI) IDAHO (ID) ILLINOIS (IL) INDIANA (IN) IOWA (IA) KANSAS (KS) KENTUCKY (KY) LOUISIANA (LA) MAINE (ME) MARYLAND (MD) MASSACHUSETTS (MA) MICHIGAN (MI) MINNESOTA (MN) MISSISSIPPI (MS) MISSOURI (MO) MONTANA (MT) NEBRASKA (NE) NEVADA (NV) NEW HAMPSHIRE (NH) NEW JERSEY (NJ) NEW MEXICO (NM) NEW YORK (NY) NORTH CAROLINA (NC) NORTH DAKOTA (ND) OHIO (OH) OKLAHOMA (OK) OREGON (OR) PENNSYLVANIA (PA) RHODE ISLAND (RI) SOUTH CAROLINA (SC) SOUTH DAKOTA (SD) TENNESSEE (TN) TEXAS (TX) UTAH (UT) VERMONT (VT) VIRGINIA (VA) WASHINGTON (WA) WEST VIRGINIA (WV) WISCONSIN (WI) WYOMING (WY)
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Payment Information

1. Payment Type Choose One MasterCard Visa American Express Discover Check
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3. Expiration Month: 01 02 03 04 05 06 07 08 09 10 11 12
4. Expiration Yr: 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021