Business Facilities LiveXchange delegate application form

October 23-25, 2011
Rancho Bernardo Inn,
San Diego, CA

Once you have submitted an invitation request, the company and project information you have provided will be reviewed to determine if your project(s) meet the necessary criteria to attend the event. You will receive a response to your request within two working days.

This event is capacity controlled and all registration requests are subject to availability.

We are sensitive to the confidentiality of your project details, and sponsors attending Business Facilities LiveXchange will be provided with access to this information only after the official facility delegate/sponsor review process begins.

If your project requires additional confidentiality restrictions, please contact us after submitting and indicate your needs in the comments section of this form at the end.

Please use the below form to complete your Application.

If you need assistance with this form or would like to speak with Todd Conine at 732-559-1263.


(* required information)

Your Contact Information: *


Required for on site communication
 
 

Independent Representatives:
Are you an independent site consultant or real estate professional representing a company? *
Yes, I am an independent site consultant or a real estate professional.
No, I am an employee of a company seeking to expand.

If you are an independent site consultant or real estate professional wishing to represent a company with relocation or expansion plans, please enter the name of the company you'll represent at LiveXchange:


All references to "your company" in the remainder of the questionnaire will apply to the company you are representing.

If you have more than one company you’d like to represent, please fill out this form and submit it once for each company you’ll represent with a note in the comments section at the bottom of each form.


Your Organization's Profile:



Have you ever been involved in a site selection, expansion or relocation project? *
Yes
No


If yes, how many of these projects have you been involved in?
1-5
6-10
11-15
More than 15

What organizations have you conducted site selection, expansion or relocation projects with?



Approximate number of employees at all locations: *
1-19
20-49
50-99
100-499
500-999
Above 1000


Please indicate which stages of the location selection process you will be involved in concerning your expansion/relocation project: (Select all that apply) *
Final Decision
Preliminary Decision
Information Gathering
No Role
Other

Do you currently have financing for your expansion/relocation project? *
Yes
No

Are you a start-up organization? *
Yes
No

Please indicate the kinds of facilities your company wants to relocate/expand: (Select all that apply) *
Corporate Headquarters
Office Complex
Call Center
Back Office/Shared Service Center
Healthcare
Energy Related
R&D Facility 		Laboratory
Distribution/Warehouse Facility
Manufacturing Assembly
Industrial Facility
Repair/Testing
Transportation/Aviation
Other


This project will represent a(n): (Select all that apply) *
Expansion into a new geographic area
Consolidation into a new geographic area
Relocation
Other

In your view what are the most important site selection factors to your project. (Select all that apply) *
Availability of qualified labor
Workforce stability
Protection from future labor supply/cost pressure
Labor Cost
Union risk
Natural disaster risk
Available building
Fully served/ready to go sites
Land/building costs 		Distance to markets and/or suppliers
Four lane highway linkage
Transportation services
Electric power
Natural gas
Water/sewer
Telecom
Taxes
Environmental
Other
When would you like to make a location decision? *
After LiveXchange in 2011
Sometime in 2012
2013-2014

Approximately how many full-time (or full-time equivalent) jobs will be created in the new location? *
1-10
11-20
21-39
40-75
76-150
101-250
251-500
501-1000
Above 1000

Please estimate the annual payroll at your new location (including health and retirement benefits): *
Less Than 1 Million
1 Million - 1.9 Million
2 Million - 2.9 Million
3 Million - 4.9 Million
5 Million - 9.9 Million
Above 10 Million

Please indicate the expected capital investment needed to bring this new facility to fully operational status (including construction, upgrades, machinery, other one-time costs): *
Less Than 1 Million
1 Million - 9.9 Million
10 Million - 24.9 Million
25 Million - 49.9 Million
50 Million - 99.9 Million
Above 100 Million

For your new facility or facilities, which of the following will you consider: (Select all that apply) *
Buying an existing facility and customizing it
Building on an empty plot
Building on undeveloped greenfield property
Building on reclaimed brownfield property

How important do you think tax and other financial incentives offered by the community will be to your project? *
Critical
Important
Not a Primary Consideration

Approximately how many square feet of usable building space will be needed in your new facility/facilities? *
5000 Sq. Ft. or less
5,001-10,000 Sq. Ft.
10,001-20,000 Sq. Ft.
20,001-30,000 Sq. Ft.
30,001-50,000 Sq. Ft.
50,001-100,000 Sq. Ft.
100,001-200,000 Sq. Ft.
Above 200,000 Sq. Ft.

How many acres of property, will you need, if applicable? *
Not Applicable to my Project
Less Than 1 Acre
1-5 Acres
6-10 Acres
11-20 Acres
Above 20 Acres

What zoning would your project most likely fall under: (Select all that apply) *
Heavy Industrial
Light Industrial
Office
Other

Which states, provinces, and countries are you most interested in meeting? This is for our information only. You will be asked a few weeks before the event to tell us specifically which locations you would like to meet with out of those attending. *

New England
Connecticut
Massachusetts
Maine
New Hampshire
Rhode Island
Vermont

Mid Atlantic
New York
New Jersey
Pennsylvania
Delaware
Maryland
West Virginia

South
Alabama
Arkansas
Florida
Georgia
Kentucky
Louisiana
Mississippi
North Carolina
Oklahoma
South Carolina
Tennessee
Texas
Virginia

Great Lakes
Illinois
Indiana
Michigan
Minnesota
Ohio
Wisconsin

Plains
Iowa
Kansas
Missouri
Nebraska
North Dakota
South Dakota

Mountain
Arizona
Colorado
Idaho
Montana
Nevada
New Mexico
Utah
Wyoming

Pacific
Alaska
California
Hawaii
Oregon
Washington

Canada
Alberta
British Columbia
New Brunswick
Manitoba
Newfoundland
Nova Scotia
Ontario
Prince Edward Isl.
Quebec
Saskatchewan

Other International
Caribbean
Central America
South America
United Kingdom
Eastern Europe
Western Europe
Asia and Pacific
Australia and New Zealand






If there are aspects to your project that are not covered in this form, please describe them below. You can also use this space to tell us about any special requests you have regarding your attendance at LiveXchange.

Comments:




How did you hear about this event?*
Please check all that apply:
E-mail
Print Ad
Direct Mail
Search Engine 		Business Facilities Website
Other
If you checked 'Other', please describe here:




NETWORKING EVENTS:

   
We have two Networking Event Outings available on Sunday, October 23, 2011. Please select from a golf outing at the Rancho Bernardo Golf Resort, a walking tour of the US Naval Base in San Diego or neither.
Please indicate whether you will participate: *
Golfing
Naval Tour
Neither
 
If Golfing:  
I'll bring my own clubs
I'll rent clubs - right-handed
I'll rent clubs - left-handed




TRAVEL ARRANGEMENTS:

All approved delegates will receive a $350 travel stipend towards airfare and ground transfer, you’ll also receive complementary deluxe accommodations and meals in San Diego.



Late Cancellation Fee Agreement:


Cancellation Fee Explained:
Attendance at Business Facilities LiveXchange is complimentary.
 However if you cancel your registration after September 2, 2011, you will be liable for a cancellation fee of $1,000.
  • This is structured to ensure that attendees are committed to the selection process and to ensure that they are not holding a place open that they do not intend to take.


  • We anticipate the demand for places to be greater than we can accommodate, and any cancellations will deprive another executive of the potential opportunity to attend.


  • In the event of a cancellation, the attendee may suggest a suitable replacement. However, acceptance of the replacement is at the full discretion of Group C Media, Inc., parent company of Business Facilities and Business Facilities LiveXchange.


This invitation has been extended to you as a representative of the organization stated above. If you are no longer employed by the above company, your invitation to Business Facilities LiveXchange is no longer valid. Please contact Group C Media if you have moved to a new company. If appropriate, we will extend a new invitation to you representing your new employer.

While your participation at Business Facilities LiveXchange is complimentary, you are responsible for your incidental charges including (but not limited to): telephone calls, drinks at the bar, and items from the gift shops. Group C Media reserves the right to review and cancel this registration at any time.

I understand this form constitutes a firm booking and confirm that the details supplied on this form are true and correct.

Credit Card Information:

I authorize Group C Media, Inc., the parent company of Business Facilities LiveXchange, to charge the following credit card in the case of cancellation as defined above:
 
Card Type* Visa Mastercard AMEX
 
Name On Card*
Card Number*
Expiration Date* /
Security Code*
(Your security code is the last three digits on the signature strip for VISA/MC, or the four-digit code on front of AMEX, just above and to the right of the account number.)

Your card will be authenticated upon receipt of this form, but no charges will be made against it until a cancellation is confirmed.

I understand that by entering my full name below and clicking on the Accept button that this constitutes a firm registration and my agreement to all the Terms and Conditions should I be approved to attend Business Facilities LiveXchange.
Full Name:*