Www.massleague.org
Massachusetts League of Community Health Centers
Community Health Institute
Exhibitor Registration Form
MAY 10, 2012
Resort and Conference Center at Hyannis, 34 Scudder Avenue, Hyannis
Table Exhibit Fee - $600
Contact person who is filling out this form: ______________________________________________________
Name of person attending the Exhibit Fair:______________________________________________
Title _________________________________________________________________________________________
Organization __________________________________________________________________________________
Address ____ __________________________________________________________________________________
City _______________________________ State __________________ Zip_______________________________
E-mail address ________________________________________________________________________
Phone _________________________________ Fax ___________________________________________________
Badge Name(s) of Trade Show Representatives. Please give the names of up to two representatives for the booth – after two there is a $50 charge per person
❑ My check is enclosed and made payable to Massachusetts League of Community Health Centers.
Please return your registration form and $600 payment by April 18, 2012 to:
Massachusetts League of Community Health Centers, 40 Court Street, 10th Floor, Boston, MA 02108. Any questions please call or email Denise McCauley at 617-988-2244 or dmccauley@ Fax number: 617-426-0097
Table registration includes: one-six-foot table and chair, luncheon for two booth representatives and an opportunity to attend conference sessions on Thursday.
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