If Paying Online, Submit Registration Form Upon Completion.
If Paying with Check, Please Print Form Upon Completion and Mail, Along with Sponsor Fee, To :


Please send all correspondence, prizes and cash donations to address above before OCTOBER 2, 2008.

*Contact Person:
*Company Name:
*Address:
*City:		*State:		*Zip:
*Email Address:
Office Phone:		Cell:		Fax:
*Sponsor Level:	-Select- New Bronze Silver Gold Platinum	*Amount:
*Attending Banquet:	-Select- Yes No	Number Attending:
*Shirt Sizes:	-Select- Small Medium Large X-Large 2x 3x   -Select- Small Medium Large X-Large 2x 3x   -Select- Small Medium Large X-Large 2x 3x   -Select- Small Medium Large X-Large 2x 3x   -Select- Small Medium Large X-Large 2x 3x   -Select- Small Medium Large X-Large 2x 3x
Names of Representative(s) Attending: *Required if Attending
Products and Equipment to Be Displayed:
Please list the prizes that you will be donating for the awards presentation during the banquet. Sponsor fee and prizes must be received No Later Then October 2, 2008.
Prize Description		Value Per Item		Quantity
PAYMENT INFORMATION:
*First Name:		*Last Name:
*Billing Address:
*City		*State:		*Zip:
*Credit Card Number		*Expiration:	-Select- 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December	-Select- 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017
*CCV