2024 Inaugural Southern Tier NY 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 LaborGMPIAFFIAMAWIATSEBoilermakersIBEWIBTICWUCIFPTEILAILWUInsulatorsIronworkersIUAIUE / CWAIUECIUOEIUPAIUPATLIUNAMTTDNACUNALCNATBUNATCANFLPAOPCMIAOPEIUOtherPASSRoofersRWDSUSAG-AFTRASEIUSIUSMARTSPFPATWUUAUAWUBCUFCWUMWAUSWUWUAOther Union (Submit Your Own) Local # 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 ($3,500 & 2 Table Prizes) Bronze Sponsor ($1,750 & 1 Table Prize) Veteran Sponsor($2,000 & 1 Table Prize) Platinum Sponsors: Choose a Combination of 5 Table Prizes*Choose a Prize Combo5 Barnett Crossbows5 Savage Axis II5 Orca Coolers4 Barnett Crossbows / 1 Savage Axis II4 Barnett Crossbows / 1 Orca Cooler4 Savage Axis II / 1 Orca Cooler4 Savage Axis II / 1 Barnett Crossbow4 Orca Coolers / 1 Savage Axis II4 Orca Cooler / 1 Barnett Crossbows3 Barnett Crossbows / 2 Savage Axis II3 Barnett Crossbows / 2 Orca Coolers3 Savage Axis II / 2 Barnett Crossbows3 Savage Axis II / 2 Orca Coolers3 Orca Coolers / 2 Barnett Crossbows3 Orca Coolers / 2 Savage Axis II1 Savage Axis II / 2 Orca Coolers / 2 Barnett Crossbows1 Orca Cooler / 2 Savage Axis II / 2 Barnett Crossbows1 Barnett Crossbow / 2 Savage Axis II / 2 Orca Coolers1 Savage Axis II / 3 Orca Coolers / 1 Barnett Crossbow1 Orca Cooler / 3 Savage Axis II / 1 Barnett Crossbow1 Savage Axis II / 3 Barnett Crossbows / 1 Orca CoolerGold Sponsors: Choose a Combination of 3 Table Prizes*Choose a Prize Combo2 Savage Axis II / 1 Orca Cooler2 Savage Axis II / 1 Barnett Crossbow1 Savage Axis II / 2 Orca Coolers1 Barnett Crossbow / 2 Orca Coolers2 Barnett Crossbows / 1 Orca Cooler2 Barnett Crossbows / 1 Savage Axis3 Savage Axis II3 Orca Coolers3 Barnett CrossbowsSilver Sponsors: Choose a Combination of 2 Table Prizes*Choose a Prize Combo1 Savage Axis II / 1 Orca Cooler1 Savage Axis II / 1 Barnett Crossbow1 Orca Cooler / 1 Barnett Crossbow2 Savage Axis II2 Orca Coolers2 Barnett CrossbowBronze Sponsors: Choose 1 Table Prize*Choose a Prize Combo1 Savage Axis II1 Orca Cooler1 Barnett CrossbowVeteran Sponsors: Choose 1 Table Prize*Choose a Prize Combo1 Savage Axis II1 Orca Cooler1 Barnett CrossbowTotal $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: Event Name 4800 Northfield Lane Spring Hill, TN 37174Credit 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