Mail Exhibitor Form

Please check this box to verify that you have read the Rules and Regulations for Texas EMS Conference 2008.You can only register if you agree to the terms.

INFORMATION USED FOR CONFERENCE PROGRAM, EXHIBITOR IDENTIFICATION AND NAME BADGE

Please enter information exactly as you want to be identified.

Firm Name

Contact Person

Address

City

State

Zip

Phone

FAX

Contact Person's E-mail Address

Type of Business/Products

Company Website

Number of exhibit hall client passes needed: (No charge for 10 or less, not personalized.)

Please have someone give me a call about special marketing opportunities and sponsorships:

Name:

Phone Number

Exhibitor Representatives: Two representatives per exhibit space are included in the registration fee. Additional representatives are welcome and will be charged $75 each--Please include this amount in your payment total. For more than six representatives, please attach list.

Last Name

First Name

Title/Certification

Please reserve the following exhibit space(s). An 20% administrative fee charged for refunds prior to 10/1/2008. No refunds after 10/1/2008.

No.of Booths:	Booth Type	Fee (each)
	10'X10' Regular Booth ($875) ($875 before 9/1/07)	$975.00
	10'X10' Corner Booth ($950) ($950 before 9/1/07)	$950.00
	30'X30' Island ($7,000) (Includes full page ad in Conference Program)	$7,000.00
	20'X30' Vehicle Space ($1075)	$1,075.00
	Helicopter Space ($1150)	$1,150.00
	Extra Booth Representatives ($75 each))	$75.00
	TOTAL

Booth location request: Enter booth number(s), all efforts will be made to honor booth choices.
View Floorplan	1st Choice	2nd Choice	3rd Choice	4th Choice	Let us choose for you

PAYMENT PROCESSING
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Expiration Date	Month: Year:
*Cardholder Signature*