The Ohio Early Stage Summit V We look forward to seeing you at this year's information-packed two-day event. To submit your reservation, please complete the form below. Reservations must be received on or before September 21, 2009. Reception October 14, 2009, 5:00 p.m. - 7:30p.m., Ohio Statehouse Atrium Panels and Presentations October 15, 2009, 7:30 a.m. - 3:30p.m., Renaissance Hotel Day One: October 14, 2009 Day Two: October 15, 2009
	*Required field. First Name*     Last Name*     Organization*     Street Address*     Street Address 2     City*     State*   Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Dst of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Other Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code*     Phone*     Fax     E-mail Address*     I plan to attend*   Oct 14 - Informal Reception  Oct 15 - Lunch  Oct 15 - Panels/Presentations  Overnight      Accommodations      Required?*   Yes  No  Dietary      Restrictions?*    Yes  No  Additional      Information        Special Overnight Accommodation Rates Available Reservations can be made at the Renaissance Columbus Hotel, 50 North 3rd Street, by calling Renaissance reservations at 1-800-468-3571 or the hotel directly at 614-228-5050. Attendees should indicate that they are attending the Ohio Capital Fund event in order to receive the special room rate of $129 Single or Double. Parking options are available at downtown garages or the Ohio Statehouse. Directions to the Statehouse | Renaissance Hotel View Larger Map Statehouse Parking Information    Special Note to our Public Sector Clients and Friends Ohio ethics laws prohibit us from giving certain public officials a gift, including food and beverages, of "substantial value." We estimate the cost of this event will be approximately $25 per person for food, beverage, and a modest favor. While we do not consider this amount to be "substantial", we understand that some jurisdications or individuals may have a stringent policy regarding meals and gifts. If you have questions, contact Allyson Bosse at 513-361-7622 to discuss options and alternative arrangements that will enable you to attend this event without violating ethical restrictions. Sincerely, Buckeye Venture Partners, LLC.