Name

Position

Email Address

Organization

Address

City, State, Zip

Telephone

000-000-0000

Fax

000-000-0000

Website

http://

County

Brief description of products and/or services to be exhibited, including price range:

Select your exhibition level:

Please select ... County Board/Non-Profit - 1 Day: $40 County Board/Non-Profit - 2 Days: $75 County Board/Non-Profit - 3 Days: $100 For-Profit Organization - 1 Day: $70 For-Profit Organization - 2 Days: $125 For-Profit Organizaton - 3 Days: $150
Non-Profit Tax ID # (if applicable)      

Days you will exhibit:
(check all that apply)

  Wednesday
  Thursday
  Friday

Number of 8' tables
(Prices are per one 8 ft. table)

  tables x level =  $ table cost

Number of chairs per table

1 2

Will your exhibit require an electrical outlet?

  Please select ... Yes No

Number of lunches (for vendors not registered for the convention) - $18 each

  lunches  x $20 = $ lunch cost

Total Cost

$