b'Spring Conference CSIA 13May 2-3, 2023 French Lick Springs Hotel8670 West State Road 56 - French Lick, IN 47432Please print clearly or Register Online at www.csiaonline.orgUse a separate form for each registrant, and duplicate form as necessary. Company Name____________________________________________________________________________________________________ Attendee Name _____________________________________Attendee Email _________________________________________________ Company Address __________________________________________________________________________________________________ City ______________________________________State _______ Zip ____________Country __________________________________ Work Phone ____________________________________________Cell Phone_______________________________________________ First Time Attendee YES NO Conference RegistrationSponsorship Opportunities MemberNon-MemberIncludes Recognition on CSIA Social Media, in Event Program,Signage, Pre and Post-Conference Materials and a Sponsor Ribbon on FULL Registration$595$695Name Badge. Includes all Educational Sessions, Breakfast (Tues. & Wed.), Lunch (Tues.)Reception (Tues.), & Golf Outing Greens Fees, Box Lunch, & Drink Tickets (Wed.) EDUCATION ONLYRegistration $350$450An Individual Hole Sponsor$125Includes all Educational Sessions, Breakfast (Tues. & Wed.), Lunch (Tues.) andLongest Drive Contest Sponsor $150Reception (Tues.) RECEPTION ONLY Registration $100$150 Closest to the Pin Contest Sponsor $150Includes Reception (Tues.) Full Page, Full Color Ad in Onsite Program Book $150GOLF ONLY Registration $250$350Includes Golf Outing Greens Fees, Box Lunch, & Drink Tickets (Wed.) Conference Audio/Visual Sponsor $250Subtotal A $_______________Labor Manual Sponsor $250Contractors Education Sponsor $350Hotel Room Block: Golf Beverage Cart Sponsor $500Room Rate: $154 + 13% total Occupancy tax (includes 7% Indiana Sales tax; 4% OccupancyBreakfast Sponsor (Tuesday) $500tax; 2% Historic Occupancy tax).Breakfast Sponsor (Wednesday) $500Individual Call inAll housing arrangements and reservations will be made, modified orcancelled by individuals calling the Resort directly 1-888-936-9360 and using the group codeGolf Lunch Sponsor (Wednesday) $5000523CSI. Individuals must identify themselves as being with Central States InsulationAssociation at the time the reservation is made in order to receive the special group rate. The Group Rate is guaranteed for reservations made on or before the Cutoff Date.Any Lunch Sponsor (Tuesday) $750reservations made after the Cutoff Date shall be at the Hotels current available rate.In the event that an individual guest fails to attend, the individuals credit card will be charged for theReception Food Sponsor (Tuesday) $750first nights room reservation for the no show, plus applicable taxes. Room Block CUT-OFF DATE:Reception Beverage Sponsor (Tuesday) $750The cut-off date is April 1, 2023. Unreserved rooms will be released at 12:01 AM on this date. Reservations made after the cutoff date may be given at the Group Rate and will be based on Hotel availability at that time.Subtotal B $_______________ Total Payment DueA + B$______________ Cancellation Policy Check to CSIA VisaMCAmExpDiscover All cancellations must be received in writing. A $15Card # ______________________________________Exp. Date _______ CVV: _______ processing fee applies to all cancellations. No refunds will be given after April 17, 2023.Name on Card____________________________ Billing Zip Code _______All refunds will be processed after the conference. RETURN TO: CSIA - 7250 Poe Ave. Suite 410 - Dayton, Ohio 45414 orFAX TO: 937-278-0317 QUESTIONS?Contact Rachel at:888-294-0084 orrpinkus@assnsoffice.com csiaonline.org'