SCMA 2019 Annual Conference & Expo – Exhibitor/Sponsor Registration – Fort Worth, TX "Finding a Path Through the Membrane Maze"Hilton Fort Worth | Fort Worth, TXAugust 21-23, 2019 RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Middle InitialLast Name*Suffix (i.e.: Ph.D., P.E., Jr.)Company*Job Title*Address*City*State*Zip/Postal Code*Country*Telephone*Call PhoneEmail*Enter registered attendee's email address Website Billing Contact InformationEnter billing contact information, if applicableBilling Contact Name First Last Billing Contact EmailEnter billing contact's email address Billing Contact Telephone Communication and Data Sharing PreferenceSCMA has been diligent in Data Security and being compliant with US and other Nations regulations.Emails about SCMA/Affiliate Events, Newsletters, and/or Upcoming Activities are welcome*Authorization for receiving publication email notification from SCMA. (applies to all email addresses on this form)YesNoNetworking with other SCMA Members, Operators, Attendees, Speakers, Moderators, Sponsors, Board Members, and others interested with membranes is approved, share my contact information (cell phone # will not be included)*YesNo Sponsor OpportunitiesAll sponsorship is available on a first-come, first-serve basis and recorded based upon receipt of registration form and full payment. • Networking Event Sponsor Level Includes recognition as the Fun Networking Event Sponsor, and 1 Exhibit package or 2 Full Registrants • SOLD OUT - Tote Bag Sponsor Level Includes Logo on bags, recognition on the event as a Bag Sponsor and 2 Full Registrants • Platinum Level: Includes 1 Exhibit Space or 2 Full Registrants, and Recognition at Welcome Reception and Lunch Events • Gold Level: Includes 1 Exhibit Space or 2 Full Registrants, and Recognition at Lunch Events • Silver Level: Recognition at Refreshment Breaks • Bronze Level: Recognition at Interactive Break-Out SessionsAll sponsors will receive: • List of attendees sent via e-mail two weeks prior • Acknowledgement in the attendee materials (100-word company description, please email to SCMA • Sign recognition during the programEvent Sponsor*Networking Event Sponsor, $2,500SOLD OUT - Bag Sponsor, $2,500Platinum Sponsor, $2,000Gold Sponsor, $1,500Silver Sponsor, $800Bronze Sponsor, $500SOLD OUT - Awards Sponsor, $600No SponsorshipSponsorship Package: Your Choice*Included in the sponsor fee.Exhibit Package (Includes 1 Attendee with Table-Top Exhibit)2 Full AttendeesAre you the Exhibit Attendee?*Yes, the same as aboveNo, different than aboveCompany Description*100-word company descriptionUpload Company Logoplease provide a High Resolution, 300 DPI or greaterExhibit OpportunitiesAll sponsorship is available on a first-come, first-serve basis and recorded based upon receipt of registration form and full payment.All Table Top Exhibitors will receive: • One 6’ Table (Chairs are available upon request) • One full attendee registration to the Conference • Electricity is available from the Hotel for an additional fee • List of attendees sent via e-mail two weeks priorExhibit Space*Spaces are selected onsite - first come, first served.Table Top Exhibit, $750No ExhibitAre you the Exhibit Attendee?*Yes, the same as aboveNo, different than above Included Attendee 1Salutation - Included Attendee 1*Mr.Mrs.Ms.Dr.First Name - Included Attendee 1*Last Name - Included Attendee 1*Company - Included Attendee 1*Job Title - Included Attendee 1*Address - Included Attendee 1*City - Included Attendee 1*State - Included Attendee 1*Zip/Postal Code - Included Attendee 1*Country - Included Attendee 1*Telephone - Included Attendee 1*Email - Included Attendee 1* Included Attendee 2Salutation - Included Attendee 2*Mr.Mrs.Ms.Dr.First Name - Included Attendee 2*Last Name - Included Attendee 2*Company - Included Attendee 2*Job Title - Included Attendee 2*Address - Included Attendee 2*City - Included Attendee 2*State - Included Attendee 2*Zip/Postal Code - Included Attendee 2*Country - Included Attendee 2*Telephone - Included Attendee 2*Email - Included Attendee 2* Total Registration FeeTotal Registration Fee $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck (Bank Wire w/o processing fee) - Online PaymentCheckInvoice Comments/QuestionsIf you would like a copy of the invoice/receipt sent to another*If yes, you would like a copy of the invoice/receipt sent to another other than the attendee please enter information below.Yes, send copy of invoice/receipt to:No, don't need a copy sentName* First Last Email Address* Comments Cancellations/RefundsWritten cancellation requests received by SCMA on or before Aug. 1, 2019 will receive a refund, less a 25% processing fee. Full payment is required if cancellation is received on or after Aug. 2, 2019 - no refunds and no credits for future events will be granted. However, substitutions may be made at any time. SCMA reserves the right to make changes in programs and speakers, or to cancel programs when conditions beyond its control prevail. Every effort will be made to contact each enrollee if a program is cancelled. If a program is not held, SCMA’s liability is limited to the refund of the program fee only. CAPTCHA