TABLE REGISTRATION FORM LIMITED SPACE AVAILABLE How to Register: 1) E-mail:
[email protected] 2) Fax: (212) 564-6053
To register please complete all portions of this form. Please print legibly using one form per person. You must be a lender to secure a table. All representatives must be registered for the Convention to attend.
___________________________________________________________ ___________________________________________________________ Name (Representative #1) Nickname for Badge ___________________________________________________________ ___________________________________________________________ Job Title Company ___________________________________________________________ ___________________________________________________________ Company Address City State Zip ___________________________________________________________ ___________________________________________________________ Telephone Email Do you want your email listed in the directory? □ Yes or □ No Type of Organization □ □ □ □ □ □
Bank Affiliated ABL Broker Business Development Corporation Community Bank Debt Advisory Entrepreneurial Finance & Factoring
□ □ □ □ □ □
Equipment & Leasing FinTech Hedge Fund International ABL & Factoring Inventory Finance Large, Non-bank
□ □ □ □ □ □
2nd Lien/Junior Debt Lender Merchant Cash Advance Middle Market ABL Private Equity Firm Supply Chain Finance Syndicated ABL/Capital Markets
□ □ □ □
Trade Finance/Purchase Order Traditional Factoring Turnaround Management Other
REGISTRATION FEES
You must be a lender to secure a table. Table includes up to three representatives. Representatives must be registered for the Convention.
FUNDING EXCHANGE TABLE
□ $695
Payment Method □ VISA □ MasterCard □ AmEx □ Discover □ Check Enclosed (payable to CFA) Account # __________________________________________________________ Exp. Date __________________ Cardholder’s Name ___________________________________________________Signature ___________________ Billing Card Address Same as Company Address □ Billing Address _________________________________________________________________________________ Representative #2 (name, title, e-mail) _________________________________________________________________________________________ _________________________________________________________________________________________ Representative #3 (name, title, e-mail) _________________________________________________________________________________________ _________________________________________________________________________________________
Payment must be included for registration to be processed Limited # of tables, first-come, first-served. Filling out the form does not guarantee a table. The Funding Exchange takes place on November 8, 2017 from 12:00 – 4:00 p.m. Tables are set-up with CFA lenders only. You must be registered for the Convention to obtain a table. No booth materials – no flashy sell-sheets. Just uniform signage provided by the CFA. Appointments (by both lenders and other participants) will be made for 15-minute blocks and a maximum of 10 appointments in advance to ensure availability.