Question Title * Please provide us with the following information: Name: Job Title: Company: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Website: Email Address: Phone Number: The following questions will assist our underwriter committee in the determination of DEAM14 Demo Hall participants (due to high demand, not all can be accepted): Question Title * Type of product(s) and/or service(s) - check all that apply: ATS Compliance Solution Consulting Job Distribution Job Search Engine Microsites/Web Development Recruitment Advertising Recruitment Technology Social Media ------------------------------- I am a Member/Employer I am a DirectEmployers Partner Comments: Question Title * Description of organization: Question Title * Please describe products and services: Question Title * Year founded: Question Title * Our pedestals were a great success at DEAM13. If a monitor was provided once again, how would you utilize the technology? Question Title * What percentage of your clients are our Members (http://www.directemployers.org/about/member-companies/)? 0-24% 25-49% 50-74% 75-100% Question Title * Please provide two client references (name, company, email, phone): Question Title * Please indicate your level of interest for DEAM14 (March 25-27): Very Interested Interested Not Interested $35,000 Platinum $35,000 Platinum Very Interested $35,000 Platinum Interested $35,000 Platinum Not Interested $30,000 Gold + Reception $30,000 Gold + Reception Very Interested $30,000 Gold + Reception Interested $30,000 Gold + Reception Not Interested $25,000 Gold $25,000 Gold Very Interested $25,000 Gold Interested $25,000 Gold Not Interested $25,000 Silver + Keynote $25,000 Silver + Keynote Very Interested $25,000 Silver + Keynote Interested $25,000 Silver + Keynote Not Interested $15,000 Silver $15,000 Silver Very Interested $15,000 Silver Interested $15,000 Silver Not Interested $15,000 Bronze + Wi-Fi $15,000 Bronze + Wi-Fi Very Interested $15,000 Bronze + Wi-Fi Interested $15,000 Bronze + Wi-Fi Not Interested $10,000 Bronze $10,000 Bronze Very Interested $10,000 Bronze Interested $10,000 Bronze Not Interested $5,000+ Member Contributor (Members ONLY) $5,000+ Member Contributor (Members ONLY) Very Interested $5,000+ Member Contributor (Members ONLY) Interested $5,000+ Member Contributor (Members ONLY) Not Interested Comments: Underwriter packages are subject to change. Indicating interest does not secure a spot. All submissions must be reviewed by the DEAM14 Underwriter Committee. Question Title * If your organization's request for participation is accepted, how would you like to be invoiced? Full payment in 2013 Half payment in 2013, half payment in January 2014 Full payment in January 2014 Thank you for your interest!DEAM14 (DirectEmployers Annual Meeting & Conference)March 25-27Washington, D.C.http://deam14.directemployers.org Submit