Program Sponsors Get your Company Logo Here

ONLINE Registration Below or DOWNLOAD Printable Flyer

Contact: Jean Barlage

Company Name and Registration Contact

Company Name or Public/State Organization *

Registration Contact: First and Last Name *

Number of Attendees

Indicate the number of attendees and/or number of state or public officials below.

No. of Attendees

No. Attendees who are State, Town, or Public Officials at No Cost**

NOTE: **Public Officials and State Employees: For reporting purposes and compliance with CT state ethics requirements, you will need to sign in as acceptance of the $45 (value of the conference) from CCIA – not to exceed an individual annual total of $49.99 received from CCIA. Pursuant to the CT State Code of Ethics General Statutes 1-97 (d) CCIA is required to inform you in writing if CCIA makes an expenditure on your behalf, as a public official or state employee and is required to report the expenditure/event to the State. Reporting is not necessary if you reimburse CCIA $45 (the full cost of the event) prior to May 08, 2026.

Attendee Names

Please list all attendee names below. Check the box if the registrant is a public official and/or state employee.

First & Last Name (1)

Check if State Employee

First & Last Name (2)

Check if State Employee

First & Last Name (3)

Check if State Employee

First & Last Name (4)

Check if State Employee

First & Last Name (5)

Check if State Employee

First & Last Name (6)

Check if State Employee

First & Last Name (7)

Check if State Employee

First & Last Name (8)

Check if State Employee

First & Last Name (9)

Check if State Employee

First &Last Name (10)

Check if State Employee

SPONSORSHIP OPPORTUNITIES

Sponsorship Benefits

Program Sponsor: Logo in Highlights, promotional materials, and slideshow; full-page ad; Table for 10.
Platinum Sponsor: Full-page ad; logo on slideshow; Table for 10
Gold Sponsor: Full-page ad; logo on slideshow
Silver Sponsor: Half-page ad; logo on slideshow
Vendor Display Sponsor: Display table; quarter-page ad; 2 event tickets

Select Sponsorship

$5,000 Program Sponsor

$3,000 Platinum

$2,000 Gold

$1,000 Silver

$1,500 Vendor Display

Clear Selection

Program & Platinum Sponsors: Includes a table of 10. Do not pay the $45 per person fee. Enter $0 in the Registration Due field.

Vendor Display Sponsors: Includes 2 event tickets. If using both tickets, do not pay the $45 fee. Enter $0 in the Registration Due field.

Upload Logo

Upload Ad

$ Registration Due ($45 pp) *

+

$ Sponsorship Due

=

$TOTAL DUE *

Payment Options *

Credit Card- upon submission of this form

Mail Check to: CAAPA, 912 Silas Deane Highway, Suite 112, Wethersfield, CT 06109

Clear Selection

Contributions or gifts to CAAPA are not deductible as charitable contributions for federal income tax purposes.
Registration and attendance at CAAPA events constitutes an agreement by the attendee to the use and distribution of photos.

Your form submission WILL be encrypted using SSL to ensure your privacy.

Calendar


S	M	T	W	T	F	S
1	2	3	4	5	6	7
8	9	10	11	12	13	14
15	16	17	18	19	20	21
22	23	24	25	26	27	28
29	30	31


S	M	T	W	T	F	S
1	2	3	4	5	6	7
8	9	10	11	12	13	14
15	16	17	18	19	20	21
22	23	24	25	26	27	28
29	30	31


S	M	T	W	T	F	S
1	2	3	4	5	6	7
8	9	10	11	12	13	14
15	16	17	18	19	20	21
22	23	24	25	26	27	28
29	30	31


S	M	T	W	T	F	S
1	2	3	4	5	6	7
8	9	10	11	12	13	14
15	16	17	18	19	20	21
22	23	24	25	26	27	28
29	30	31