Vendor Conference and Exhibit Registration Form
March 21-23, 2012
To participate in the Vendor Exhibition the Affiliate Member must have paid current dues and be in good standing
Company Name:
*
Point of Contact:
*
Address:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
Phone:
*
Email Address:
*
Membership Fee $80.00 - due January each year, Conference Registration $50.00
TOTAL
- $130 total if paid before February 21, 2012, $155 total if paid after February 21, 2012.
Conference Registration
($50 per attendee if paid prior to February 21, 2012, $75 per if paid after February 21, 2012
Attendee:
Attendee:
Attendee:
8'Table Spot ($325 before February 21, 2012, $475 after February 21, 2012)
Electricity required
Wall Space required
Table Sharing Fee $100 - Name of Primary Vendor:
Parking Spot Needed ($200 per spot may not overlap)
Note: Wall and electrical space is limited. Please provide extension cords if you need electric and tape for coverage. FLAGFA will attempt to accomodate wall space but cannot guarantee all requests. Requests will be prioritized based on vendor registration dates.
Any Questions please contact Vicki Duval at 954-345-2215
We appreciate your participation and look forward to seeing each of you in September!
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