119 Washington Avenue , 2nd floor, Albany, NY 12210 Phone 518- 462-3717 Fax 518-432-5902

VENDOR AGREEMENT FORM

Company Name: ____________________________________ Contact Person: _______________________________
Address: _________________________________________________________________________________________
Phone number: ______________________ Cell: ____________________ Email: ____________________________

A-la-carte Specifics Price

PACKAGES Fee Selected
Newsletter Ad Size:
Diamond $1900
Classified Ad Duration:
Platinum $1500
Web Button Ad Duration:
Gold $1000
E-Blast Ad Duration:
Silver $750
Membership Labels Member $125
Bronze $500
Non-member $200
Total Webinars $100 per ad

! CONFERENCE
! ! ! !
Fee ! !
Selected ! ! PAYMENT INFORMATION
! !
OPTIONS! ! ! ! ! ! !
! ! ! ! ! ! ! ! ! TOTAL DUE =
!Presidents
! reception
! ! $1000
! ! ! ! ! Payment Method (circle) Check payable to NYSOTA
!Vendor Booth
! ! ! ! ! ! ! ! ! ! !
$400
! ! ! ! ! ! ! ! ! ! ! ! AMEX/ VISA/ MASTERCARD
!Full page! brochure
! ad ! !
$350 ! ! ! ! Card Holder Name: ________________________________
! ! ! ! ! ! ! ! ! Card Number: ____________________________________
!1/2 pg !
brochure !ad ! !
$200 ! ! ! ! Exp Date: _______________!Security Code: _________
! ! ! ! ! ! ! ! !
!CEU Presentation
! ! ! $250
! ! ! ! ! Authorization Sig & Date
! ! ! ! ! ! ! ! !
Conference Bag $200
!Stuffing ! ! ! ! ! ! ! ! ________________________________________________
! ! ! ! ! ! ! ! !
!Break Sponsorship
! ! ! !
$150 ! ! ! ! NOTE: Payment must be received before order can be processed.
! ! ! ! ! ! ! ! ! Please send to the address listed at the top of form.
Total