Vendor Registration Card

Vendor Registration Card

Frontiers in Primary Care 2020

April 23-25, 2020 Regional Training Center, Casper, Wyo.

Company name:_______________________________ Main contact e-mail:____________________________ Names of attending representatives: _____________________________________________ _____________________________________________ _____________________________________________ We will:

Sponsor an event Booth is included (contact Evie)

Reserve a booth in the vendor room, $750 if payment is received BEFORE Feb. 28, 2020.

Reserve a booth in the vendor room, $850 if payment is received AFTER Feb. 28.

Reserve Booth 1-7, $1,000.

(See right for table choices)

Payment will be made by credit card Credit Card #_______________________________________ Exp. Date:_________ 3-digit security code (on back):_______ Amount to be charged:______________________________ Name on credit card:________________________________ Billing address: _____________________________________ ___________________________________________________ Phone # of card holder:______________________________

Contributors will get recognition at the conference. Please mail checks payable to Wyoming Medical Center, Attn: Evie Franke, 1233 E. Second St., Casper, WY 82601. Tax ID# 83-0279242. Please remit by March 31, 2020.

Set-up begins at noon on Thursday, April 23, 2020.

Please select three preferred table locations. After your fee is received, your table will be assigned. 1st Choice:__________________________________ 2nd Choice:_________________________________ 3rd Choice:_________________________________

See the table layout diagrams below.

ENTRANCE

1

2

MEETING ROOM

3

4

5 67

20 19 18 17 16 15

Break and

Breakfast Room

14

8 9 10 11 12 13

Registration must be returned by March 31, 2020, for participation in the conference. NOEXCEPTIONS.

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