Annual Meeting VENDOR Registration Page Annual Meeting Registration VENDOR Company Name * Company Address Company Address Address Line 1 Address Line 1 Address Line 2 Address Line 2 City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Company Address Main Contact First Name * First Main Contact Last Name * Last Email * Phone Provide a brief company description Business Type ManufacturerDistributorServiceSoftwareOther Shirt Size SmallMediumLargeX-Large2X-Large3X-Large Registration Options * Vendor Booth & Dues - $540Vendor Booth Only (Dues must have been previously paid) - $385TEST - $25 Non-Member Operator Fees: * None1 Non-Member Operator- $2652 Non-Member Operators- $5303 Non-Member Operators- $7954 Non-Member Operators- $10604 Non-Member Operators- $1325 Member Technician Fees: * None1 Member Technician $932 Member Technicians $1863 Member Technicians $2794 Member Technicians $3725 Member Technicians $4656 Member Technicians $5587 Member Technicians $6518 Member Technicians $7449 Member Technicians $83710 Member Technicians $93011 Member Technicians $102312 Member Technicians $111613 Member Technicians $120914 Member Technicians $130215 Member Technicians $1395 Sponsorship Options * NONE Logo on back of shirt - $25 Annual Meeting Lunch Sponsor - $2000 Annual Meeting Coffee Sponsor - $500 Annual Meeting Breakfast Sponsor - $1500 Annual Meeting Dinner Sponsor - $3000 Advertising in Quarterly Newsletter * NoneBusiness Card Size Ad - $2801/4 Page Ad - $4601/2 Page Ad - $840Full Page Ad - $1140 Total How would you like to pay? PayPal Credit Card Credit Card Payment Credit Card Payment Credit Card Payment Credit Card Payment Month 123456789101112 Credit Card Payment Year 20262027202820292030203120322033203420352036 Credit Card Payment Submit
