Online and Check by Mail payment options available at submission. Conference Registration Form 2022 "*" indicates required fields 1General Information2Sponsor Registration3Exhibitor Registration4General Registration5Payment Section6Confirmation General InformationEarly registration deadline is September 1, 2022. Company Name:* Name* First Last Address:* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Address:* Enter Email Confirm Email Phone Number:*Registration Type* General Registration Sponsor Registration For exhibit information, please contact Aimee Andres at (618) 980-6523 or aandres@irpt.net Sponsor RegistrationSponsor Name* Contact Name* First Last SPONSORSHIP TABLE OF BENEFITS Benefits Levels Table Silver Hotel Bag Gold Diamond Lunch and Learn Reception Program Listing Program Bio Conference Signage Pre-Conference Acknowledgement and Website Display Conference Banner Inclusion in Backdrop Conference Admission Ticket(s)($645 Value Each) 1 2 2 4 IRPT Membership($825 Value) IRPT Affiliate Membership($175 Value) Half Page 2022-2023 Membership Directory Ad($750 Value) Full Page 2022-2023 Membership Directory Ad($1500 Value) Half Page Ad in Conference Program(Sponsors Only) Full Page Ad in Conference Program(Sponsors Only) Exhibit Booth Pre-Session Speaking Opportunity or Video Registration List 14-days Prior 15-Minute Lunch Presentation Table Signage Buffet Signage At-Reception Banner and Signage Bar Signage Sponsorship Level* Reception Sponsor - $8,000 Lunch and Learn Sponsor - $7,000 Diamond Sponsor - $6,000 Level Gold Sponsor - $3,500 Level Silver Sponsor - $1,500 Level Table Sponser - $500 HiddenExhibit Information For exhibit information, please contact Aimee Andres at (618) 980-6523 or aandres@irpt.net Exhibitor RegistrationExhibitors will be provided with a standard, skirted 8x8 trade show booth, 1 covered 6’ table and 2 chairs. Stand-alone exhibits are welcome with prior notice. Each booth includes electric and one conference admission. Exhibit cost is $3,500.00. Exhibit Times Monday, October 3: Set-up begins at 10:00 am Tuesday, October 4: 8:00 am – 5:00 pm Wednesday, October 5: 8:00 am – 5:00 pm (Exhibitor Breakdown) Thursday, October 6: 8:00 am – 12:00 pm Exhibitor Breakdown (Optional) Each paid exhibitor will only have one complimentary admission to the conference, a $625 value.Registrant Name* Company Name* Note - Reception, Lunch and Learn, and Diamond Sponsors receive (1) free exhibit booth. This deduction will be adjusted at the end of the form.Exhibit Cost Price: HiddenExhibition Tables*Add the exhibit1 Conference RegistrationI am going to be registered as:* Member Non-Member Federal Government Employee Select the total number of attendees (including yourself).Reception Sponsors receive (4) free conference admissions.Lunch and Learn & Diamond Sponsors receive (2) free conference admissions.Gold Sponsors receive (1) free conference admission.These deductions will be adjusted at the end of the form.Conference Attendee (members) Price: Number of attendees (members)*Add quantity12345678910Excluding Spouse/PartnerConference Attendee (non-members) Price: Number of attendees (non-member)*Add quantity12345678910Excluding Spouse/PartnerConference Attendee (federal government employee) Price: Number of attendees (federal government employee)*Add quantity12345678910Excluding Spouse/PartnerName (Attendee #1)* First Last Name (Attendee #2)* First Last Name (Attendee #3)* First Last Name (Attendee #4)* First Last Name (Attendee #5)* First Last Name (Attendee #6)* First Last Name (Attendee #7)* First Last Name (Attendee #8)* First Last Name (Attendee #9)* First Last Name (Attendee #10)* First Last Spouse/Partner Fee (Optional) Yes, my spouse/partner will attend. $175 No, my spouse/partner will not attend. Spouse/Partner Name* First Last Payment SectionMethod of Payment* Check by Mail Credit Card Credit Card + 3% Convenience FeeCredit Card Address* Same as previous Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Registration must be paid in full on or before September 1, 2022 to avoid Late Registration Fee Please send payment to: IRPT: 4625 Lindell Boulevard Central West End, Suite 200 - #2179 St. Louis MO 63108 . Questions? Please call Aimee at 618-980-6523 or email aandres@irpt.netSubtotal $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Reception Sponsor - $8,000 receives (4) conference admissions $0.00 Lunch and Learn Sponsor - $7,000 receives (2) conference admissions $0.00 Lunch and Learn Sponsor - $7,000 receives (2) conference admissions $0.00 Lunch and Learn Sponsor - $7,000 receives (2) conference admissions $0.00 Lunch and Learn Sponsor - $7,000 receives (2) conference admissions $0.00 Diamond Sponsor - $6,000 receives (2) conference admissions $0.00 Diamond Sponsor - $6,000 receives (2) conference admissions $0.00 Diamond Sponsor - $6,000 receives (2) conference admissions $0.00 Diamond Sponsor - $6,000 receives (2) conference admissions $0.00 Reception sponsor receives (1) exhibit booth $0.00 Lunch and Learn sponsor receives (1) exhibit booth $0.00 Diamond sponsor receives (1) exhibit booth $0.00 Gold Sponsor- $3,500 receives (1) conference admission $0.00 Gold Sponsor- $3,500 receives (1) conference admission $0.00 Each paid exhibitor will only have (1) complimentary admission to the conference $0.00 Each paid exhibitor will only have (1) complimentary admission to the conference $0.00 3% Credit Card Fee $0.00 Total {all_fields}OptionFirst OptionSecond OptionThird OptionEmailThis field is for validation purposes and should be left unchanged.