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Registration Form CPPC 2021 Convention


CPPC 2021 Convention
Harrah’s Las Vegas Casino & Hotel – Las Vegas, NV
  October 29th & 30th, 2021 ____________________________________________________________________
REGISTRATION FORM
(Register by selecting fill-in registration form. "Click here"
After you complete the attached form, return to cppc@claimsnet.org for invoicing and on-line payment options.

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 9-1     after 9-1          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 Saturday 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: _______________

Friday Oct 29th  Pre-Convention Optional Sessions:
 Military Roundtable & Repair Only

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.

Name: ___________________ Session: ____________

Name: ___________________ Session: ____________

Name: ___________________ Session: ____________

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

Questions?  Contact Alan Jobe at the CPPC Office

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 and event banner as well.

Name Badge Sponsor:                   $750.00
Program Sponsor:                         $750.00
Reception Entertainment:        Negotiable / Shared *
Military Roundtable Sponsor: Negotiable / Shared *
Repair Only Sponsor:            Negotiable / Shared *
Break Sponsor:                        Negotiable / Shared *
Meal Sponsor:                          Negotiable / Shared *

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

If you respond by October 10th, 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 10-10 -2021!

(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, we will be pleased to provide you with a complimentary one year membership with your registration.                                                  
             Please initial here to activate:  ________
  

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

    

 

 

(Register by selecting fill-in registration form. "Click here"
After you complete the attached form, return to cppc@claimsnet.org for invoicing and on-line payment options.