APTAC SPRING 2008 CONFERENCE
EXHIBITOR REGISTRATION FORM
Company Name
  First Name Last Name    
Representative 1 Title 1
Representative 2 Title 2
Mailing Address
Address 2
City State Zip
Phone: Fax:
Email:
Exhibit Booth Fee $5000  Corporate member
 		   $3000.00 Non-Member - One Booth at the Spring Conference. 
See Membership Rates for the benefits of becoming a member of APTAC

PAYMENT INFORMATION

AN INVOICE WILL BE E-MAILED TO YOU.
Please provide below the name and email address of the person responsible for payment if different from above:

Name:
E-Mail address:
Please make check payable to: APTAC
PO Box 1607
Orange, TX 77631-1607
Credit Card payment: Payment by MasterCard, Visa or American Express may be made by calling PHS at 409-886-0125.  Please ask for the APTAC office.
PLEASE DO NOT PROVIDE CREDIT CARD INFORMATION ON THIS FORM


 

Web maintained by Shelia Rhoads, PHS
Copyright © 1999 [PHS/APTAC]. All rights reserved.
Revised: 03/01/05