Regional Safety Seminar

Affiliate Member Exhibitor Contract

Check the box next to each regional safety seminar where you wish exhibit. The Affiliate Member exhibitor registration fee is $400 per seminar.

Western Region - $400 2009 TBD Add Electrical - $50	Canadian Region - $400 2009 TBD Add Electrical - $50
Central Region - $400 November 11-13, 2009 Galveston, TX Add Electrical - $50	Southeastern Region - $400 February 2-4, 2009 Gainesville, FL Add Electrical - $50
Eastern Region - $400 2009 TBD Add Electrical - $50	Northeastern Region - $400 2009 TBD Add Electrical - $50
Please list each company employee who will be attending the seminar. Enter each name EXACTLY as you want it to appear on their exhibitor badge. Representative #1: Representative #2: