Exhibitor Registraton Form

Firm Name______________________________________________

Street Address___________________________________________

Mailing Address__________________________________________

City_____________________________________________________

State______________________Zip Code______________________

Contact Name____________________________________________

Title_____________________________________________________

Telephone Number _(___) _________________________________

Fax Telephone Number ____(___)___________________________

E-Mail address____________________________________________

Type of product or service____________________________________________________

I will need ______ tables at $100 per table. Please check if you require______electricity _____info on telephone connection.

Please remit this form and fee to:

Steve Reames

Sam Houston State University

P.O. Box 2263

Huntsville, Texas 77341

Telephone: (409) 294-1591

or e-mail : csc_sar@shsu.edu