Supplier's Day Exhibitor Registration

This page is for vendor registration. Members, please use member registration. This registration form is submitted to Sue Riippa, event coordinator. If you have any questions, please contact Sue at (269) 964-9481, or email her directly. *Indicates required information
*Your Name:**
*Company:**
*Contact at the Booth:**
*Address:**
*City:**
*State:**
*ZIP:**
*Day Phone:**
Alternate Phone:
FAX:
*Email:**
Company Website:
*Signage Should Read:**
*Name Tags Should Read:**
Products/Services*: (for Booth Placement & Show Booklet):
Please enter a quantity on applicable lines, and the total amount due will be calculated for you: Qty: Supplier's Day, April 18, 2012 ($225 first booth, $125 each additional booth) Qty: Electricity required ($25) Qty: Wine Dinner, $75 per person Qty: Door Prize Contribution (Increments of $50) Qty: Sorry-Sold Out! Appetizer Sponsor at Wine Dinner ($500)-Call for availability first. Qty: Sorry-Sold Out! Company sponsor with logo featured on front of show booklet ($100) Qty: Company sponsor with logo featured on inside cover of show booklet ($50) I will bring a door prize. Note: Hotel is additional and is the responsibility of the exhibitor.
Comments/Questions:
Total Amount Due:
		To submit your registration, and Pay Online Now. If you have a problem with this form, please click here for a printed version of the registration form, which you may submit by mail. Thank you.