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2024 Perinatal Partnership Conference Exhibitor Registration
Click here for the event brochure (PDF)
Event Date:
Sunday, 29 September 2024 - 7:00am
to
Wednesday, 2 October 2024 - 5:30pm
First Name
*
Last Name
*
Address
*
Address (extra field)
City
*
State
*
- Select State -
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Marianas Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip
*
Email
*
Phone Number
*
Profession/Credentials
*
Employer
Name of Exhibiting Organization
*
Select Your Type of Vendor
*
Bronze [$600.00]
Silver [$850.00]
Gold [$1,100.00]
Non-Profit [$100.00]
Retail $75 + 10% of sales (payment due the last day of exhibiting) [$75.00]
Number of Representatives
*
Name(s) of Representatives
*
Will provide a door prize
*
Yes
No
Do you need any extra tables in addition to the one (1) provided?
*
No
Yes
Every table exceeding the one provided is $45.00 each.
Extra Tables ($45 per table)
How many? quantity
*
Will you need a standard electrical outlet (120v)
*
Standard 120v Electrical Outlet [$50.00]
No, Thank You [$0.00]
Will you need wireless internet?
*
Wireless Internet (additional $35)
No, Thank You
Will need to ship materials/supplies for storage (for additional fee TBD)
Yes
No
Would like conference registration information
Yes
No
Would like conference hotel reservation information
Yes
No
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