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2nd ANNUAL NCPSMA WESTERN CONVENTION/WORKSHOP May 26-28, 2010 EXHIBITOR REGISTRATION FORM
Please read carefully and fill out and return both pages. Please remember each person registering must pay $50-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 May 5, 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 ____________________ We 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 $50 each-no free passes with display purchase.
_________________________ _________________________ _________________________
_________________________ _________________________ _________________________
_________________________ _________________________ _________________________
If registering more than nine people, please list names on a separate sheet and attach to registration form. Please remember you must register each person attending @ $50 each. Please print or type. You must register EACH person. No free passes with display space purchase. Display Space ($350 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 space. Vendor rules (including display size) ( ) One outside space are the same for inside and outside spaces. ( ) Two outside spaces Sponsorships Refreshment Break (minimum of $350 required)
Amount of Sponsorship or Co-Sponsorship $ ______________________________
Ladies Program (minimum of $350 required)
Amount of Sponsorship or Co-Sponsorship $ _______________________________ Membership(s) Amount of membership(s) @ $20 each $ ________________________________ Please include completed Membership Form
Meal Ticket(s) @ $60.00 each See attached Information Letter for explanation $ ________________________________
Amount Enclosed for Each Registration(s) $50 for each registration-no free passes $ ___________________________
Display Space(s) $____________________________ Sponsorship(s) $ ___________________________ Membership(s) $ ___________________________ Meal Ticket(s) $ ___________________________ Total Enclosed $ ____________________________
Note: PO # will not hold a display space – only a check or money order. We do not accept credit cards. Make checks payable to NCPSMA. Mail to: NCPSMA, 630 Adams Ridge Road, State Road, NC 28676
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