2021 8th Annual Illinois State Conservation Dinner Please complete the following questions for the Table Sponsor ContactSponsoring Union/Company* Contact Name* First Last Select a Union (choose "Friend of Labor" if not a union)*AFA / CWAAFGEAFSCMEAFTAFTRAAGMAALPAATUBACBCTGMBLEBRSCWAFriend of LaborGMPIAFFIAMAWIATSEIBBIBEWIBTICWUCIFPTEILAILWUInsulatorsIronworkersIUAIUE / CWAIUECIUOEIUPAIUPATLIUNAMTTDNACUNALCNATBUNATCANFLPAOPCMIAOPEIUOtherPASSRoofersRWDSUSAG-AFTRASEIUSIUSMARTUAUAWUBCUFCWUMWAUSWUWUALocal # Phone*Email* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Product NameChoose Sponsorship Level(s)* Platinum Sponsor ($10,000 & 5 Table Prizes) Gold Sponsor ($5,000 & 3 Table Prizes) Silver Sponsor ($3,000 & 2 Table Prizes) Bronze Sponsor ($1,500 & 1 Table Prize) Veteran Sponsor($2,000 & 1 Table Prize) Platinum Sponsors: Choose a Combination of 5 Table Prizes*Choose a Prize Combo1 Remington / 4 Orca Coolers2 Remingtons / 3 Orca Coolers3 Remingtons / 2 Orca Coolers4 Remingtons / 1 Orca Coolers5 Remingtons5 Orca CoolersGold Sponsors: Choose a Combination of 3 Table Prizes*Choose a Prize Combo2 Remingtons / 1 Orca Cooler1 Remingtons / 2 Orca Coolers3 Remingtons3 Orca CoolersSilver Sponsors: Choose a Combination of 2 Table Prizes*Choose a Prize Combo1 Remington / 1 Orca Cooler2 Remingtons2 Orca CoolersBronze Sponsors: Choose 1 Table Prize*Choose a Prize Combo1 Remington1 Orca CoolerVeteran Sponsors: Choose 1 Table Prize*Choose a Prize Combo1 Remington1 Orca CoolerTotal $0.00 Payment InformationHow would you like to pay?*Choose Payment MethodCredit Card - OnlineCheck - Mail-InPlease mail your check to: Union Sportsmen's Alliance Attn: 8th Annual Illinois State Conservation Dinner Registration 4800 Northfield Lane Spring Hill, TN 37174 Credit Card*Card Details Cardholder Name Billing Address* Same as previous Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code