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CPPC 2018 Convention Registration Form

CPPC 2018 Convention
Lago Mar Beach Resort & Club - Ft. Lauderdale, FL
September 24th & 25th, 2018

REGISTRATION FORM
On-line registration & payment is available through a link at the CPPC website, www.claimsnet.org )

On-line registration through the following link:

http://cppc.approvedhorizon.com/RegEvent_COM.aspx?PID=CPPC&EID=2018Conv


Or you can: Print word document form here!

SECTION A … Attendees

If this is your first time to attend a CPPC event, please place an asterisk (*) by your name.

1.____________________________________________

2.____________________________________________

3.____________________________________________

4.____________________________________________
Company: ____________________________________
Address:    ____________________________________

                  ____________________________________

Note:  some firms prefer showing a metro area on the name badge.  If YOU prefer a specific listing, please list here:         _______________________________________ 

Email: _______________________________________ 

Tel:      _______________________________________

Convention Registration Costs… depend upon WHEN your registration PAYMENT is received:

Attendees        before 8-01     after 8-1          door

First person        $249              $259             $269

Second person    $239              $249             $259

Any additional   $229               $239             $249

SECTION B Guests for food events

Guest tickets for Tuesday Night’s Reception or for any other meals are available for $50 each, per event, if accompanying an attendee.  Otherwise cost is $75 for a non-attendee to participate in any food event.  Please provide the names and payment for any such requests and specify event(s):

1.________________________ Event: _____________    

2.________________________ Event: _____________ 

Monday Sept 24th Pre-Convention Optional Sessions:
Military Roundtable & Technology Class

These sessions are at no additional charge to attendees; but we do need a count for appropriate planning. Please advise, if you will be attending one of these sessions.

Attendee Name: _____________ Session: ___________

Attendee Name: _____________ Session: ___________

Attendee Name: _____________ Session: ___________

Note: Any and all refunds are at the discretion of the CPPC
office, due to schedule times and contractual obligations with other parties.

 Claims Prevention and Procedure Council, Inc.
P.O.   Box 1117 Newburgh, IN 47629
Ph: 866-276-5656 Fax: 812-858-0599
Email: cppc@claimsnet.org   Web: www.claimsnet.org

 

SECTION C... Advertising / Sponsorship – Info

Special Sponsorships are available on a first come basis for those that want to do more than usual Advertising in the Program and include a program ad as well. 

   Name Badge Sponsor:    $750.00
   Program Sponsor:          $750.00
   Speaker Sponsor:           Negotiable/Shared *   Reception Entertainment: Negotiable / Shared *   Break Sponsorships:         Negotiable / Shared *   Meal Sponsorships:           Negotiable / Shared *  

*: Negotiable amounts are at a minimum of $500 and be a combination of Sponsors 

If you respond by September 7th, we will be happy to include your name as a Sponsor in our “Official Convention Program” along with a corresponding Ad and an event banner.  

Your Black and White Ad options for listings: 

Bronze -    $50 for a business card size ad
Silver -      $100 for a quarter page ad
Gold -        $150 for a half page ad
Platinum - $250 for a full page ad 

Any donation amount is accepted and appreciated and will be acknowledged. If we do NOT receive a special ad from you with your donation, we will prepare a simple “compliments of” type ad for the program on your behalf. 

Show your support, by placing an ad even if you are not able to attend the event this year. 

Remember the deadline is 9-7 -2018!

(We can not guarantee your inclusion in the program after that date.)
_____________________________________________
TOTALS:
Section A    $______________
Section B    $______________
Section C    $______________
Grand Total:   $__________

Payment by check can be mailed to the CPPC address below along with your registration form. 

If paying by Visa, Master Card, Discover or American Express email or mail the registration form to our office for processing.  An invoice will be emailed back to you for payment through our on-line secure payment portal.  If choosing this option, please sign
here: _____________________________________

If you are not a CPPC member, or have previously been a member, we will be pleased to provide you with a complimentary one year membership with your registration. Please initial here to activate:  ______   

   Questions?  Contact Alan Jobe at the CPPC Office.

Link for on-line registration:

http://cppc.approvedhorizon.com/RegEvent_COM.aspx?PID=CPPC&EID=2018Conv

 
Convention Registration -
Print word document form here!