2010 Expo Vendor/ Table Registration

2010 Autism Expo Registration for Service Providers and Vendor Tables

Families do NOT need to register for our event.

If you are an Autism Service Provider or Autism Vendor and would like to be part of the Families with ASD's 5th Annual Autism Expo, then please download the 2010 Autism Expo Registration Packet. Over the past four years, Families with ASD has helped autism vendors and service providers network and connect with over 10,000 attendees to our one-day events.

Mail your registration packet to:

Families with ASD
5989 Meijer Drive
Suite 9
Milford, OH 45150
513-444-4979
helpingfamilieswithautism@yahoo.com

Hit Control P on your computer to print this screen.

Families with Autism Spectrum Disorders, Inc
“Helping Families with Autism”

Families with ASD ’s 2010 Autism Expo Registration Packet

5th Annual Families with ASD’sAutism Expo
Saturday, September 25th, 2010
10 a.m. to 4p.m.

Live Oaks Campus
5956 Buckwheat
Milford, OH 45150
513-444-4979
www.familieswithasd.org

Keynote Speaker: Dr. Stephen Shore

Families with ASD 5th Annual Autism Expo REGISTRATION
 Register by E-mail: familieswithasd@yahoo.com (Email registration must have credit card number included) .
 Register by mail: Families with ASD, 5989 Meijer Drive, Suite 9, Milford, OH 45150. (Check Or Money Order made out to Families with ASD)
For Questions Please Call 513-444-4979 Or E-mail Julia at familieswithasd@yahoo.com or Doug at helpingfamilieswithautism@yahoo.com

Name : (Preferred name for name badge)__________________________________________
Organization (If applicable) *Contact Person (Who can we call/email?)______________________________________________________________
Street Address City State ZIP_______________________________________________________________________________________________
Phone ( ) Fax ( ) E-mail : Web :_______________________________________________________________________________________________
Special Request:________________________________________________________________________________________
* Please Circle or Put an X in the boxes for which you are registering .

2010 Autism Expo
Early Registration: June 1st – June 30th
Late Registration: July 1st- July 31st

Take-One Table: If your organization is unable to make the Expo, but would like your flyer or catalogs handed out at our event, sign up for the Take-one table.
Early Registration is $50 per each set of handouts(please see next sheet for more information)
Late Registration is $75 per each set of hand-outs(please see next sheet for more information)

Non-Profit Service Providers: Free information/ No Sales (Must show proof of EIN Number or 501 (c) 3 Status with IRS.
Early Registration $200
Late Registration $300

For- Profit Service Providers: Free Information/ No Sales
Early Registration $200
Late Registration $300

Autism Vendor: Non-Profit Sales (must have proof of the 501 (c ) 3 statusSales (autism only products) Must have approval

Early Registration $350
Late Registration $450

Autism Vendor: For-Profit Sales (Autism related products only) Must have approval.
Early Registration $400
Late Registration $500

Break-Out Session Room for 45 mins. (Must be approved before Registration is paid) Please see next page for more information.

Early Registration $250 with paid Expo table: $350 (Break-out session Only)
Late Registration $300 with paid Expo table : $400 (Break-out session only)

Electricity: Electric & Extension cord
Early Registration $50
Late Registration $75

Extra Table (Do you want more room?)

Early Registration $150 with paid table registration
Late Registration $200 with paid table registration

Extra Name Tags: ( per each extra name tag), please write the names

Early Registration $10 each extra tag
Late Registration $15 eacg extra tag

Payment can also be made via checks or money orders. They should be made out to: Families with ASD and mailed to
5989 Meijer Drive, Suite 9, Milford, OH 45150. Please mark * 2010 Expo Registration

*Payment and registration forms must be received by stated deadlines, or you will be charged an additional fee.

* Families with ASD reserves the right for approval for all tables, advertisements, etc… for our 2010 Families with ASD Autism
Expo and the Autism Yellow Pages © .

Please share with any other organization you feel may want to participate.

2010 Autism Expo Registration Form Payment Options

Credit Card Information : If paying by Credit Card, please fill out and send with your completed registration form.
Name on card:*
Card number:* CV V:*:
What is CVV?
Also known as the Cardholder Verification Value (CVV) or Customer Identification Number (CID/4DBC), these
three or four digit numbers help ensure that the physical card is in the cardholder’s possession while donating or
shopping online helping to prevent unauthorized or fraudulent use.
Where can I find it? The 3-digit code is located on the back of your card, inside the signature area. Typically the
signature panel will have a series of numbers, but only the last three digits make up the CVV code.

Card type:* Visa, Master Card ,or Discover:
Expiration date:* Month____________ Year____________________

Billing Information: for Credit Card Payments Only
Required Fields*
____If the billing information is the same as the contact information check here.
If not please fill out the information below:
*First Name: *Last Name:
*Mailing Address:
Suite /Apartment number
*City *State *Zip
*Phone: Email:

Remember, we must receive your Expo registration form, payment, and Advertisement (if you are purchasing an advertisement in the 2010 Autism Yellow Pages), no later than July 31, 2010 to be included in the 2010/11 Autism Yellow Pages © We are sorry, but there are NO Refunds for cancelled registrations and/or failure to appear at our Expo.

Dear 2010 Autism Expo Attendee,
Families with ASD is proud to announce our 4th Annual Autism Expo will be held on Saturday, September 25, 2010 from 10 a.m. to 4 p.m at the Live Oaks Campus 5956 Buckwheat, Milford, OH 45150. This is just down the street from our Autism Family Resource Center located at 5989 Meijer Drive, Suite 9, Milford, OH 45150.

We are very happy to announce we will again have our Annual Autism Expo on The Live Oaks Campus in Milford, OH. We are also very excited that our Keynote speaker will be Dr. Stephen Shore. In the past four years, our one-day events have reached over 10,000 families. We had families that traveled from all parts of Ohio (Cleveland, Dayton, Columbus, Delaware, Georgetown, Middleton), as well as all over Kentucky ( Lexington, Versailles, Western Kentucky, Grants Lick, Alexandria, Burlington, Florence, Dry Ridge, Summerset, and Georgetown). We had vendors and service providers coming fromWisconsin, Missouri, New York, and Maryland. Our last four Autism Expo events have been mentioned on several websites, blogs, newspaper articles, as well as mentioned on t.v and the radio! With the rate of autism on the rise, there are so many new families out there looking for help and support. Our one day Autism Expo will help you make the connections with these new families. Sign up today!

Also, if you register before July 31st , your business contact information will be included FREE in our 2010/11 Autism Yellow Pages © . Our
publication is quickly becoming a “Must have” for families, schools, and doctors offices. We are getting calls from schools, support groups, doctor’s offices and Autism training organizations for copies of our Autism Yellow Pages © . In the past four years, we have handed out over 9,000 hard copies, and over 1,000 CD’s. This year we will hand out over 3,000 Hard copies of the 2010 /11 Families with ASD Autism Yellow Pages © . Of course it is always handed out free to the public. The 2010 /11 Autism Yellow Pages © will also be available throughout the year at our Families with ASD’s Autism Family Resource Center located in Milford, OH, and will added to our searchable on-line yellow pages, at www.autismyellowpages.org .

Take-One Table: If your organization is unable to attend our Expo, but would still like to reach the thousands of families that will attend our event, you should sign up for the Take-One table. Your organization will have to mail or bring your flyer/brochures /catalogs to the Autism Family Resource Center no later than August 31st. You will be charged per set of items you have us hand out. Each set of hand-outs require an additional charge. If you have one flyer, the charge is for one item. If you have one flyer and one catalog to hand out then you would register for two items, etc…

Service Providers For- Profit and Non-Profit: To register as a service provider you must be a doctor, organization, school,therapist, individual, support group, or organization that will only be handing out free information/free samples to the public. No exchange of money at anytime at the event. If you are registering as a Non-Profit, you must submit proof of your EIN tax number or your 501 (c ) 3 status with the IRS.

Vendors For-Profit and Non-Profit: To register as a vendor, you must be a doctor, organization, school, therapist, individual or support group that will be selling autism related items, or services. (There will be an exchange of money with the general public at the Autism Expo at the Live Oaks Campus). If you are registering as a Non-Profit, you must submit proof of your 501 (c ) 3 status with the IRS.

Exhibit Space: The first to register will have their table set up in the main exhibit hall space (cafeteria). After the main exhibit hall is full, we will then use the hallways that run off the main exhibit hall.

Your 2010 Families with ASD Autism Expo Registration will include 1 table covered, 2 chairs, 2 name tags. (Tables measure about 2 ½ feet by 6 feet).
Your contact info will also be included for FREE in the 2010/11 hard copies of the Autism Yellow Pages that will be handed out at the 2010 Expo. Your Contact info will also be included FREE on-line for 1 free year.

Break-out Sessions: A way to intimately reach your audience. Share with families the services you provide in a small classroom setting. Classrooms seat no more than 30 adults. Break-out sessions must be approved. You will then be notified ofyour scheduled 45 minute time frame, and assigned a classroom. Your approved break-out session will be highlighted on our website, press releases, and will be included on the program guide handed out to families. Tables at the Expo should NOT be left unattended, so please make plans to have your table covered while you are in your break-out session. You do NOT have to have a table to qualify for a break-out session.

Times & Set-up: The Autism Expo will be open to the public from 10 a.m. to 4 p.m. on Saturday, September 25th , 2010. All registered Expo providers will have to check in no later than 8:30 a.m. to set up their table. Coffee and donuts will be provided.
The Expo will run until 4p.m. We are asking that if you register for our event to make sure that you have full coverage of your
table for the ENTIRE event. There will be no clean up before 4p.m. This is out of consideration and respect for our families
that will be attending.

EVERYONE: After we have received you registration form and payment, your organization will be added to our Autism Expo website
with a link to yours, absolutely free: www.autismexpo.org. We get over 100 unique visits per week. Send in your registration
form now to lock in the Early Bird Prices and gain more Exposure on our Autism Expo flyers/ and press releases!!
*Important 2010 Autism Expo Registration Information *
Do YouWant to Help Families living with Autism in
Cincinnati?
Then become a 2010 Families with ASD
Autism Expo Sponsor!
Let families in the Greater Cincinnati / Northern Kentucky Area know that your
business cares about families that live with autism. Show them that they are not
alone. Be part of the answer and help families living with autism make connections
and form networks by supporting Families with ASD and their annual Autism Expo .
Please contact President Doug Blecher at helpingfamilieswithautism@yahoo.com or by calling himat
513-444-4979 to set up sponsorship today.
Why Become a Sponsor of the Families with ASD’s Autism Expo?
Since September of 2006, Families with ASD has been the proud organizer of the Families with ASD Annual Autism Expo. Brining
families and service providers together so they could network. This was the first of its kind for the Greater Cincinnati/ Northern Kentucky
Area. Since the great success of our annual event, Autism Expo’s have been popping up in places all over the United States.
What is the Families with ASD Autism Expo?
The annual Families with ASD Autism Expo began in September of 2006 as an answer to the many parents that were crying
out for help. “Many families that were joining our ASD support group said they were getting the diagnosis and then out the
door. They did not know what to do, or where to go next,” says founder, Julia Ann Smith. “Our board met and said if they
have a boat show, and a home and garden show, why not have an autism show?”
Th e F ami l i e s wi t h ASD b o a r d w o r ke d h a r d a t i n v i t i n g l o c a l s e r v i c e p r o v i d e r s , t h e r a p i s t , doctors,
schools and organization that worked with children and adults on the spectrum to come and set up free information
booths. Families were then invited to come and go booth to booth to collect free information on the autism services
that were provided in their area. “We prayed for maybe 300 people to attend that first year,” says Alberta Mellon, an
ASD Board member. “We were shocked when the fire department estimated 2,200 people attended our expo. That is
when we realized the need was so great and that we had to do this as an annual event.”
Over the past four years, our one-day Autism Expo events have served over 10,000 people by helping families with autism connect
and network with service providers, therapist, doctors, schools and organizations that specialize with working with children and adults
on the spectrum. The best part of our Autism Expo’s are that they are always FREE to families.
If you would like to see video footage of the Families with ASD Autism Expo go to: "In the Tank Cincinnati" footage of our Families with
ASD Autism Expo 2006 just visit the link http://writefieldfeatures.org/Audio-Video/Audio-Video.html The Families with ASD’s Autism
Expo is a great one-day event that offers FREE guest speakers, and over 90 organizations tables so families can go to one place to get
much needed information. In the past three years, Families with ASD has had over 10,000 attendees for their annual one day events. This
event is always family centered and always, FREE to families.

For the past four years Families with ASD has printed and handed out over 9,000 hard copies of their Autism Yellow Pages © . The Autism Yellow Pages© are handed out FREE to families living with autism, schools, doctor’s offices, churches, and organizations that work with children and adults with autism.

Reach your target audience and sign up today to be included in the 2010 Families with ASD Autism Yellow Pages ©. We will print and hand out over 3,000 hard copies at our 2010 Autism Expo in September, and then will make it available online on our websites: www.familieswithasd.org
and www.autismyellowpages.org (On-line advertisements will be in full color.

In the past four years, our one-day Autism Expo events have had over 10,000 attendees. Our 2010 Autism Expo is set for Saturday, September 25 th at the Live Oaks Campus in Milford, OH. The Autism Yellow Pages are also made available throughout the year at our Families with ASD’s Autism Family Resource Center. For only $25, your organization, support group, or autism business can be included in this years 2010/11 Autism Yellow Pages ©. Our Autism Yellow Pages© are always in high demand.

Make your organization stand out. Show off your Logo, and tell families about the autism services that you provide.With each paid registration and/or advertisement also include one year free inclusion to our on-line autism yellowpages at www.autismyellowpages.org . On-line advertisements will appear in FULL-COLOR!! Purchase an advertisement today for our 2010/11 Autism Yellow Pages © . Deadline to participate is July 31, 2010.

2010/11 Autism Yellow Pages Advertisement Price List for the Hard Copies that will be handed out at the 2010 Autism Expo
Business card(BW) or Logo thumbnail (3.5 x 2 inches) = $100
½ page = $750 ¾ page = $1,000
Full Page = $1,500 Double Page = $2.500
Inside Front Cover =$5,000 (Full Color Only 1 Available )
Inside Back Cover = $5,000 (Full Color Only 1 Available)

Compare our prices to that of your local Yellow Pages or Yellow Book. Not only are our prices lower, our Autism Yellow Pages © are handed out to your target audience; Families who are looking for support for autism, and not just the general public.
2010/11 Families with ASD’Autism Yellow Pages© Registration Form
_____ I would like to be included for free on-line. Just fill out registration and mail to Families with ASD, 5989 Meijer Drive, Suite 9, Milford, OH 45150.

______ I would like to be included in the Families with ASD’s 2010/11 Autism Yellow Pages © hard copy and have my business reach over 3,000 families in my targeted audience for only $25.

Name of Organization/Business:
Business Address
Phone Number (including area code)
Fax Number (including area code)
Website:
Email:
Types of Service Your Organizations Offers Families: Please list all the services you provide families such as: support, speech therapy, child advocacy, etc… (This is limited to 5 lines/420 characters)

______ I would like to make my business stand out by purchasing an advertisement in the 2010 Autism
Yellow Pages.
_____Business card (BW) (3.5 x 2 inches) $100
_____½ page Black and White Advertisement $750
______¾ page Black and White Advertisement $1,000
______Full page Black and White Advertisement $1,500
_______Double Page Spread Black & White Advertisement $2,500
_______Inside Front Cover (Full Color) Only 1 Available $5,000
________Inside Back Cover (Full Color) Only 1 Available $5,000
Families with ASD Reserves the right to approve all advertisements for our 2010/11 Autism Yellow Pages ©. All paid advertisements must be submitted for approval before the July 31st, 2010 deadline. If you fail to submit your advertisement, there will be no refund.

Payment Types: Families with ASD can accept checks made out to Families with ASD. Checks can be mailed to Families with ASD, 5989 Meijer Drive, Suite #9, Milford, OH 45150, or arrangements can be made to drop off the check at the Families with ASD’s Autism Family Resource Center by calling: Julia Ann Smith at 513-444-4979, or emailing Julia at familieswithasd@yahoo.com

Credit Card Information : If paying by Credit Card, please fill out.
Name on card:*
Card number:* CV V:*:
What is CVV?
Also known as the Cardholder Verification Value (CVV) or Customer Identification Number (CID/4DBC), these three
or four digit numbers help ensure that the physical card is in the cardholder’s possession while donating or shopping
online helping to prevent unauthorized or fraudulent use.
Where can I find it? The 3-digit code is located on the back of your card, inside the signature area. Typically the
signature panel will have a series of numbers, but only the last three digits make up the CVV code.
Card type:* Visa, Master Card ,or Discover:
Expiration date:* Month____________ Year____________________

By signing below, and submitting your credit card information to Families with ASD, you authorize Families with ASD to process the below amount to your credit card. Your Credit Card will be processed for the amount of *$_____________ for a paid Advertisement in the 2010/11 Families with ASD Autism Yellow Pages©. By signing, I am aware of the No Refund Policy for failure to submit and approval of my advertisement by July 31, 2010. Your Signature giving Families with ASD permission to process your order:*______________________________________________________________ Date: *
_________________
Billing Information: for Credit Card Payments Only Required Fields*
____If the billing information is the same as the contact information check here.
If not please fill out the information below:
*First Name: *Last Name:
*Mailing Address:
Suite /Apartment number
*City *State *Zip
*Phone: Email:
Remember, we must receive your registration form, payment, and Advertisement (if you are purchasing an additional advertisement), no later than July 31, 2010 to be included in the 2010/11 Autism Yellow Pages © . Families with ASD has a NO Refund Policy. If you cancel your registration for any reason, fail to make payment on time, or get your advertisement and/or business information submitted before the deadline of July 31st, 2010, you will NOT receive a refund. No Refunds are given if you cancel your registration or fail to appear at the 2010 Autism Expo.

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