2009 Annual Conference

The LaQuinta Inn and Conference Center

Boone, NC

April 22 - 24, 2009

EXHIBITOR REGISTRATION

Company/Organization ________________________________________________

MailingAddress ______________________________________________________

E-MailAddress: ______________________________________________________

PhoneNumber(___)___________________ Fax _____________

Name(s)ofRepresentative(s) ___________________________________________

Single tables are $150.00 each and facility cost for each additional table. Please reserve _________ table(s) for us.

Each table will have two (2) chairs. I do ___ do not ___ need electrical power.

A Free Luncheon will be provided on Thursday April 23, 2009. One ticket will be provided to you. If you need additional tickets please let us know at the registration desk at the conference.

In addition to exhibiting, our company/organization would like to sponsor a speaker or social function with a contribution of $___________________.

WNCPHA welcomes contributions of cash or items to be given to participating members as door prizes, some of which are tied to visiting exhibitors.
Please accept our company’s/organization’s donation of $____________ in cash or please list your items below ________________________________________________________________________________________________________________________________________

My company/organization cannot attend but would like to contribute $_________ or _______________________________________________________.

Please send completed form with your payment by March 15, 2009 to:

Heather Morgan-Gulnac, Vice President WNCPHA 2009

Burke County Health Department

700 East Parker Road

Morganton, NC 28655

Tel 828 448 3210

e-mail Heather.Morgan@ncmail.net

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