Exhibitor Registration
Date
May 20 & 21, 2020
Time
7:30 am
Address
Spruce Point Inn
Boothbay Harbor, ME
Company Name
*
Company Phone
-
Area Code
Phone Number
Contact Name
*
First Name
Last Name
Contact Phone
-
Area Code
Phone Number
E-mail
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Rep 1 Name
*
First Name
Last Name
Rep 1 AARC #
Rep 2 Name
First Name
Last Name
Rep 2 AARC
Rep 3 Name
First Name
Last Name
Rep 3 AARC #
Rep 4 Name
First Name
Last Name
Rep 4 AARC #
Do you need electricity?
Yes
No
Additional Exhibitor Support
I will help sponsor a coffee break for $300.00
I will help sponsor a physician speaker for $500.00
I will help sponsor hors d'oeuvres for $300.00
I will help sponsor a non-physician speaker for $250.00
I will help sponsor the entertainment (band) for $250.00
I will help sponsor the Exhibitor game for $100.00
I wold like to donate an item to the silent auction.
Silent Auction Item
Corporate Partnerships
I would like to become a Platinum Corporate Partner for $2500.00
I would like to become a Gold Corporate Partner for $1800.00
I would like to become a Silver Corporate Partner for $1200.00
I would like to become a Bronze Corporate Partner for $900.00
Signature
*
I have read and understand the guidelines outlined by the MeSRC Exhibitor Registration Packet 2019 for the Maine Event at Spruce Point and agree to comply by them.
Comments
CAPTCHA
*
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