Member Zone 2017 December Educational Event Sponsorship Form Sponsor forms due by November 17, 2017 3RD ANNUAL LEGAL ISSUES SYMPOSIUM: SUCCESSFUL ADMINISTRATION OF RIGHT-OF-WAYS AND LOCAL PAVEMENT WARRANTIES; MASTERY SERIES: LOCAL ROAD AGENCY BUDGETING & FINANCIALS If you have questions, please contact Christina Strong at: cstrong@micountyroads.org or 517.482.1189. Company Name * Address Line 1 * Address Line 2 City * State * Select option... Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming DC Zip/Postal Code * Telephone Number * Email Address * Contact Person * See full sponsor benefits online at http://micountyroads.org/Events/December-Event $500 Sponsorship $1,000 Sponsorship (Sold Out) Sponsorship includes one registration to the event, please provide name of attendee: Payment Options (Please choose one) * Invoice (will be sent shortly after submission of this form) Credit Card (Fill out form below. Please note there is a credit card fee.) Credit Card # Expiration Date CVV Code Please upload a high-resolution logo for signage at the event.