Southern Maryland Legislative Reception Page 2
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2Southern Maryland Legislative Reception
Please complete this form and mail with your check (made payable to Tri-County Council for
Southern Maryland) to Michelle DeSoto, Tri-County Council for Southern Maryland,
P.O. Box 745, Hughesville, MD 20637
Company Name/Address: ______________________________________________________________________
_____________________________________________________________________________________________
Contact Person: ____________________________________ Phone/Fax: ________________________________
Email Address: _______________________________________________________________________________
CHESAPEAKE BAY SPONSOR
($1,500 sponsorship (TO BE PAID IN ADVANCE); receives 10 reservations)
Check here if Exhibit Booth space is desired _____
Attendees (for Name tag purposes & check-in) PLEASE PRINT CLEARLY:
1) __________________________________
2) ___________________________________
3) __________________________________
4) ___________________________________
5) __________________________________
6) ___________________________________
7) __________________________________
8) ___________________________________
9) __________________________________
10) ___________________________________
PATUXENT SPONSOR
($1,000 sponsorship (TO BE PAID IN ADVANCE); receives 8 reservations)
Check here if Exhibit Booth space is desired _____
Attendees (for Name tag purposes & check-in) PLEASE PRINT CLEARLY:
1) __________________________________
2) ___________________________________
3) __________________________________
4) ___________________________________
5) __________________________________
6) ___________________________________
7) __________________________________
8) ___________________________________
POTOMAC SPONSOR
($500 sponsorship (TO BE PAID IN ADVANCE); receives 5 reservations)
Attendees (for Name tag purposes & check-in) PLEASE PRINT CLEARLY:
1) __________________________________
2) ___________________________________
3) __________________________________
4) ___________________________________
5) __________________________________
INDIVIDUAL
($40 for each reservation (TO BE PAID IN ADVANCE)
Attendees (for Name tag purposes & check-in) PLEASE PRINT CLEARLY:
1) __________________________________
2) ___________________________________
3) __________________________________
4) ___________________________________
IN ORDER TO GUARANTEE A PRE-PRINTED NAME TAG, ATTENDEE NAMES
MUST BE RECEIVED BY FEBRUARY 12TH.
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Parent category: Letters