Return form to [email protected] or FAX (404) 795-9105 Questions? Call (614) 859-2223, email [email protected], www.ohioacc.org Lead Representative Company: Lead Rep Name: Email: Email: Cell: Address: City: State: ZIP Code: Additional Representatives Name: E-mail: Cell: Name: E-mail: Cell: Name: E-mail: Cell: Participation Selection (Sponsorships are based on availability) Payment Information TOTAL $_________________ Checks should be made payable to Ohio Chapter-ACC. Federal Tax ID #31-1315856. Mail to: 440 Laurel Chase Ct NW, Atlanta, GA 30327 Agreement ❏We understand that all exhibit displays must be prepaid in full. In the event that we cancel our exhibit, we understand that we are still obligated to I have read and agree to the terms stated: Signature ________________________________________________________ Date_____________________ Saturday, October 24, 2020 Ohio-ACC Exhibitor Reply Form: Virtual Annual Meeting ❏Gold $2500 ❏Silver $1500 ❏Exhibitor $600 the full cost of the exhibit display. ❏Platinum $3500 ❏Industry Expert Webinar Session $3500 (only with paid Platinum sponsorship)