Massachusetts League of Community Health Centers
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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