Upon receipt of the registration form, you will be contacted for your

Please fax or send this registration form with your payment option (see below) to:
RIPIN – Partnerships Conference
Attn: Marilyn McCullough
1210 Pontiac Avenue
Cranston, RI 02920
Email: [email protected]
Phone: (401) 270-0101 x 112
Fax (401) 270-7049
Organization Name:
Contact Person:
Email:
Address:
City/State/Zip:
Phone:
Fax:
E-Mail:
Exhibitor Table (name as to appear in Program Directory):
Specify Sponsorship Level:
Number in Party:
Value:
* $60.00 for each additional participant beyond the sponsorship level.
Upon receipt of the registration form, you will be contacted for your full participant
list and will be provided with the details for the day of the event.
Payment options:
Checks (payable to: RI Parent Information Network)
Visa or MasterCard:
Number on back of card (3 digits):
Cardholder Billing Address:
Cardholder Signature:
Exp. Date:
Name of cardholder:
Date:
Credit card payments may also be made through our website at www.ripin.org.
Specify Sponsorship Level:
Value:
All exhibitors must set up by 11:30 am.
If your sponsorship level includes ads and/or logo recognition, please refer to deadlines
below and submit materials to [email protected]
Logos (jpg format) submit as soon as possible for full exposure (printing deadline- March 18th)
Ads need to be submitted by April 8, 2011 (ads - pdf format)
THANK YOU FOR YOUR CONTINUED SUPPORT OF OUR
CHILDREN, YOUTH AND FAMILIES!
Sponsorship Levels
 $1,000 Event Scholarship Sponsor*
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 $10,000 Elite Conference Partner*
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Opportunity to participate in welcoming guests during opening remarks (5 minutes)
Organizational name or logo on print promotional materials and all forms of multi media, website,
Facebook and Twitter recognition (company logo) with hyper-link back to organization's site
Name or logo on give away promotional materials
(must have logos by March 18, 2011 to meet printer deadline)
Marketing materials in registration packets
Up to Ten (10) complimentary conference registrations includes afternoon refreshments,
and dinner
Banner placement behind podium in Grand Ballroom (only 5 available)
(2) 6 foot Exhibitor Tables, seating for up to 10 chairs (premium placement)
Two (2) Full page, full color ads in Program Directory (Placed in order we receive payment for sponsorship)
 $5,000 Major Community Partner*
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Recognition during opening remarks
Organizational name or logo on print promotional materials
Name or logo on give away promotional materials
Marketing materials in registration packets
Up to Five (5) complimentary conference registrations includes afternoon refreshments, and dinner
Banner placement inside Grand Ballroom (side walls) (Space is limited - first come first serve)
6 foot Exhibitor Table, up to 5 chairs (placement to follow Elite Partners)
($60 each for additional participants)
Full page, full color ad in Program Directory (Placed in order we receive payment for sponsorship)
 $2,000 Community Sponsor*
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Recognition during opening remarks
Marketing materials in registration packets
Name or logo on give away promotional materials
Two (2) complimentary conference registrations includes afternoon refreshments, and dinner
6 foot Exhibitor Table, 2 chairs
($60 each for additional participants)
Full page, full color ad in Program Directory (Placed in order we receive payment for sponsorship)
 $1,500 Conference Sponsor*
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Recognition during opening remarks
One (1) complimentary conference registration includes afternoon refreshments, and dinner
6 foot Exhibitor Table, 1 chair
($70 for 2nd participant and $60 each for additional participants)
Full page black and white ad or full color half page ad (your choice) in Program Directory
(Placed in order we receive payment for sponsorship)
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Recognition during opening remarks
Your donation will help us provide an opportunity for twelve (12) youth, parents or other family members to
attend our conference (includes conference registrations, afternoon refreshments, and dinner)
6 foot Exhibitor Table, 1 chair, conference registration for one (1), afternoon refreshments, and dinner
($70 for 2nd participant and $60 each for additional participants)
Full color half page ad in Program Directory (Placed in order we receive payment for sponsorship)
 $750 Sponsor*
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Recognition during opening remarks
One (1) complimentary conference registration includes afternoon refreshments, and dinner
6 foot Exhibitor Table, 1 chair
($70 for 2nd participant and $60 each for additional participants)
Black and white half page ad in Program Directory (Placed in order we receive payment for sponsorship)
 $500 Supporter*
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Recognition during opening remarks
One (1) complimentary conference registration includes afternoon refreshments, and dinner
6 foot Exhibitor Table, 1 chair
($70 for 2nd participant and $60 each for additional participants)
Black and white quarter page ad in Program Directory (Placed in order we receive payment for sponsorship)
 $200 Exhibitor Table*
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One (1) complimentary conference registration includes afternoon refreshments, and dinner
6 foot Exhibitor Table, 1 chair
($70 for 2nd participant and $60 each for additional participants)
Name recognition in conference packet
 $150 Promotional items in conference packets only (no attendance)
 $100 per person Individual Scholarship – (specify #: ______ and $ _______)
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Your donation will help us provide an opportunity for a youth, parent or other family member to attend our
conference by covering the cost of conference registration includes afternoon refreshments, and dinner
 Other amount (specify $________)
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Name recognition in conference packet (Name only)
Please fill out the Sponsorship / Exhibitor form on back and submit to the Rhode Island Parent
Information Network.
Thank you and we look forward to seeing you there!
* see registration form on back re: additional participants, ads and logo deadlines