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NIPHLE Training Conference
Fort Walton Beach, FL

May 14-17, 2007
Ramada Plaza Beach Resort

Event Sponsorship
Event Sponsorship LIst

Please complete and return this form to Linda McCarthy by fax, mail or e-mail
no later than 236 April 2007: 5450 Carlisle Pike - Mechanicsburg, PA 17055
Phone: (717) 770-7236 • FAX (717) 770-7009. Or e-mail word doc to linda.mccarthy@dla.mil

Name of Sponsoring Agency
Address
City/State/ZIP
Contact
Phone/ Fax/Email
Date of Sponsored Event	14 May 15 May 16 May 17 May
Sponsored Event (See List)	Event Sponsorship Amt. $
Scholarship Fund Raiser Raffle Items - At your discretion. Please specify what item(s) you will be providing:

Scholarship Fund Direct Contributons $
Student Memberships - $25.00/per x No. of Students $
Total Amount $

Check enclosed Bill me later American Express MasterCard Visa

Signature

Account # Exp. Date

Conference Schedule	Conference Speakers Needed	Help Sponsor a Conference Event
Conference Registration	Conference Speaker Application	Sponsorship Form
Exhibit Opportunity	Panel Application	Table Top Display Registration

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