VRWA Expo 2008 Exhibitor Registration
Please use one form for each company attending. Registrations must be postmarked by September 5th to receive the lower rate.
No registration will be accepted without payment. There will be no refunds. Please print or type form.
Company _______________________________________________________________________________________________
Address ________________________________________________________________________________________________
City _______________________________________ State ___________________________ Zip _______________________
Phone ____________________________ Fax ___________________ Email _________________________________________
Name of Person Attending __________________________________________________________________________________
Second Person Attending __________________________________________________________________________________
Additional Registrations ___________________________________________________________________________________
______________________________________________________________________________________________________
I need: Electricity______ Water______ Digging Area______
Table Top Display Area______ Outdoor Space (size) _________________________
_____ I will contribute door prizes describe: _____________________________________________________________
_____ I will hold a contest in my area describe: _____________________________________________________________
_____ I will furnish prizes for my contest describe: _____________________________________________________________
_____ I will be a T-Shirt Sponsor—company name only, no logos (deadline September 5th)
Put your company name on the back or sleeve of the T-Shirt? Yes___ No___
Tally It Up!
Rate Before September 5th After September 5t Amount
Registration
Member $185.00 $235.00 $_____________ .00
2nd Attendee FREE
Additional Attendee $ 35.00 $ 45.00 $_____________ .00
Non-Member $485.00 $535.00 $_____________ .00
2nd Attendee FREE
Additional Attendee $ 35.00 $ 45.00 $ _____________ .00
Non-member rate includes VRWA Membership for one (1) year
Additional Tables x $10.00 $ 10.00 x ______ $_____________ .00
T-Shirt Sponsor- company name only Back $ 75.00 $_____________ .00
T-Shirt Sponsor (only one sleeve sponsorship) Sleeve $100.00 $_____________ .00
Grand Total $_____________ .00
NO REGISTRATON WILL BE ACCEPTED WITHOUT PAYMENT
Please send registration form and check to:
(Checks payable to VRWA)
Virginia Rural Water Association
2138 Sycamore Avenue
Buena Vista, VA 24416
Check Enclosed ____ Visa____ MasterCard___
Credit Card Number: __________________________________________________________
Name on Card:________________________________________________________________
Exp Date: __ __ /__ __ 3 digit sec. code:__ __ __ Card Billing Zip Code: _________
(on signature strip on back of card)
Signature: ____________________________________________ Date:_________________