| Company Name _______________________________________________ |
| Representative ________________________________________________ |
| Address ______________________________________________________ |
| City _______________________________ State ___________ Zip ______ |
| Phone _______________________________________________________ |
| Email ________________________________________________________ |
| Web Address _________________________________________________ |
|
|
| Exhibiting Sponsors: |
|
|
____ # of booths x $399 (MHMRA members) =
|
$ _______ |
|
____ # of booths x $599 (Non-MHMRA members) =
|
$ _______ |
|
|
| For Sponsors: |
|
|
_______________________ Type of Sponsorship =
|
$ _______ |
|
Total =
|
$ _______ |
|
|
| Will you need electricity at your booth? ___ Yes ___ No |
| Will you need internet access to your booth? ___ Yes ___ No |
| (If you need electricity and/or internet access you will receive additional information at a later date) |
