NCPSMA 41st ANNUAL EASTERN CONVENTION/WORKSHOP
September 25-27, 2013
Crystal Coast Civic Center, Morehead City, NC
EXHIBITOR REGISTRATION FORM
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, 2013.
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 _________________________________
Fax Number ___________________________________
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 e-mail address ____________________________
Contact fax number _______________________________
Primary product or service your company provides ___________________________________________
Names of those you are registering. The cost is $60 each-no free passes with display purchase. This is for Registration only.
This year if you want to attend the banquet you will need to purchase a banquet ticket.
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. Please return both pages.
($325 each for members -$450 each for non-members) Outside is Outside the building
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
Sponsorship $ ________________________________
Membership(s) $ ________________________________
Amount of membership(s) @ $20 each
Please include completed Membership Form
Banquet Ticket(s) $ ________________________________
Amount Enclosed for Each
$60 for each registration-
no free passes $ ___________________________
Banquet Ticket(s) $ ___________________________
Display Space(s) $____________________________
Sponsorship(s) $ ___________________________
Membership(s) $ ___________________________
Total Enclosed $ ____________________________
Make checks payable to NCPSMA.
630 Adams Ridge Road
State Road, NC 28676
Please remember to include all pages of the Registration Form