EXHIBIT/SPONSORSHIP APPLICATION

“Special Forces for Children and Families”

3rd Annual Child Placement Conference
Wyndham Peachtree Conference Center

October 2-4, 2002

Organization Name:____________________________________________________

Contact Person:_______________________________________________________

Mailing Address:______________________________________________________

Phone:_____________________________Fax:_____________________________

EMail:____________________________Website:___________________________

Name of agency representative attending conference:___________________________

Exhibit/Sponsorship Opportunities

A. Exhibitor Number of Booths__________ Sub-total $__________

Cost: $500 per booth or $900 for two booths.

We are aware that this year’s conference overlaps with the Department of Juvenile Justice Conference. If you would like to display at both of these important events, the Placement Conference would be happy to provide you with a large sign bearing your agency’s name if you only have one agency display unit. Just check here if your display will be at the DJJ Conference and you would like us to print signage for your booth __________

*NOTE: Please be aware that conference organizers are not responsible for lost or stolen exhibit material. Please secure any valuables at your display when the table is not attended.

B. Sponsorship Sub-total $__________

Gold Sponsor ($5,000) Silver Sponsor ($2,500)

Bronze Sponsor ($1,000) Conference Host ($500)

TOTAL $__________

Please mail, fax, or email your completed application and payment to:

3rd Annual Child Placement Conference

c/o GAHSC

34 Peachtree Street, NW Suite 710

Atlanta, GA 30303

Phone: (404) 572-6170 Fax: (404) 572-6171

Email: cara@gahsc.org

Make checks payable to GAHSC. Exhibit space fills up fast so register early!