38th Annual NCPSMA Eastern Convention/Workshop

September 22-25, 2010

Exhibitor Registration Form 

We have sold out of display spaces for 2010-You can still attend as a sponsor-call Roxie Mack at 336.366.4939 for more information.

Please read carefully and fill out and return both pages. Please remember each person registering must pay $60-each. No free passes with display space purchase. Exhibitors are not allowed on the convention "floor" unless they are registered. Please make sure the check (we do not accept credit cards) is mailed with the registration form to be applied correctly. The check must accompany the forms for the postmark date to qualify for display space selection. There will be no refunds after September 2, 2010.

 PLEASE type or neatly print as name tags and company information will be printed in the program using this information. Please list the address, phone number and fax number you wish to have published in the convention/workshop program. Names of companies who do not attend but sponsor an event will also be published in the convention program.

 Information you wish to be published in the convention/workshop program:

 Company Name _______________________      Phone Number ___________________________

Address __________________________________Fax Number ____________________________

City ________________________________ State _________________ Zip ___________________

I need contact information in case of questions or an emergency situation such as postponement due to severe weather, so please list who to contact below. You can list “same” on phone and fax numbers if applicable.

Contact Name _________________________ Contact phone number ______________________

 Contact fax number ___________________ Contact e-mail address ______________________

 Primary product or service your company provides ___________________________________________

 Registration

Names of those you are registering. The cost is $60 each-no free passes with display purchase.

 ______________________          _______________________          _______________________

 ______________________          _______________________          _______________________

 ______________________          ______________________           _______________________

 If registering more than six people, please list names on a separate sheet and attach to registration form. Please remember you must register each person attending @ $60 each. No free passes with display space purchase.  Please print or type.

Display Space  -Sold out for 2010

($325 each for members -$450 each for non-members) Outside “is” Outside Courtyard 

Number of Spaces Requested. Please check appropriate box.                   (    ) One inside space

Some companies such as lawn equipment sales wish to have an                         (    ) Two inside spaces

outside (uncovered courtyard) space. Vendor rules (including                (    ) One outside

display size) are the same for inside and outside spaces.                         (    ) Two outside spaces

 Sponsorships                                                                  $ ________________________________

 Membership(s)

 Amount of membership(s) @ $20 each                         $ ________________________________

Please include completed Membership Form

 Amount Enclosed for Each

Registration(s)                                                    

$60 for each registration-no free passes $ ___________________________

Display Space(s)                                      $____________________________

Sponsorship(s)                                         $ ___________________________

Membership(s)                                         $ ___________________________

Total Enclosed                                         $ ____________________________

Make checks payable to NCPSMA.                       

Mail to:

NCPSMA

630 Adams Ridge Road

State Road, NC 28676

Please remember to include both pages of the Registration Form.

 


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