21st Annual Early Childhood Conference

Vendor Registration Form

  1. Vendor Information

    Representative's Full Name:

    Company/Organization Name:

    Company Address:

    City:

    State:

    Zip Code:

    Telephone:

    Fax:

    E-mail Address:
     
  2. Number of six-foot tables desired:
    (Includes a box lunch delivered to your table(s), coffee break, and refreshments during set up)
    1 table ($55)
    2 tables ($90)
    More than 2 ($90 + $25 per additional table)
    You have requested table(s) at a cost of
     
  3. Additional Requests:
    Wall Space
    Electricity
     
  4. Set-Up Times:
    6:00 - 8:00 P.M. on Friday, April 3
    6:30 - 7:30 A.M. on Saturday, April 4
     
  5. Payment:
    Please reserve space and bill our company
    Call credit card information in to (608)342-1314 or 1-888-281-9472
    Fax credit card information to (608)342-1454
     
  6. Our company can provide the following door prizes:

     
  7. Our company would like to be in the coupon book.
    Yes
    No

    If yes, what would you like your coupon to say?
    (You may design your own and send it to us or we can
    design it for you. Coupons are 8" x 3" and one-sided.)

     
NOTE: There will be no refunds for cancellations received after March 20, 2009.