Registration Information:
First Name MI Last Name Name for Tag Title Company Address City State Zip Code Day Phone Fax E-Mail Address Special Dietary Needs or Accommodations: Type special dietary needs or accomodation needs here.
Check here if you are interested in offering a vendor presentation Check here if you will provide door prizes - Description: Type the description of your door prize(s) offering here. Registration and Fees:
Full Exhibitor Registration (includes one full participant registration)
$500.00
$575.00
Additional Fees
Electricity at booth at $25 per day
$25.00
Additional table in your booth?
$30.00/day
TOTAL DUE
Please click yes on the pop-up box.