TEXAS CONCLAVE EXHIBITOR REGISTRATION FORM

TEXAS CONCLAVE EXHIBITOR REGISTRATION FORM Arlington Convention Center  October 10-12, 2016 Form & fees are due on or before August 31

Name of Organization to Appear on Imprinted Sign

Brief Description of Your Organization

Name of Key Contact:

Limit 3 Reps per booth space - Extra Reps $75ea, up to 2 extra reps per booth space - CK Box 10

Names of Reps In the Booth:

Mailing Address ___________________________________________________________________________________ City _______________________________________________ State ______________ Zip________________________ Work Phone ____________________________ Email ____________________________________________________ Cell Phone ______________________________ Web Site__________________________________________________ YES, We are Committed for both days, Oct. 10-12 IN ADDITION, we are paying a fee to have our materials distributed to each participant as a Bag Sponsor - See box 5 below I NEED ELECTRICITY Check this Box No Extra Charge - Extra Outlets Box 12 CONTACT US about providing Break Time Drawing Give-a-ways We Plan to Set-up on Sunday

We Plan to Set-up on Monday

Oct. 9, 5:30-11:00pm Check the Box to the left

Oct. 10, 7:00-10:00am Check the Box to the left

NO, We cannot be an exhibitor this year, but keep us on your mailing list NO, We cannot be an exhibitor this year, however, we are paying a fee to have our materials distributed to each participant as Bag a Sponsor - See box 6 below

Single Booth @ $475 Includes…  Floor Space Rental (10 ft x 10 ft)

       

Carpet (10 ft x 10 ft) Pipe & Drape (3’ sides, 8’ back) 1 Elec. Outlet (check electricity box) 1 Table Covered/Skirted (8 ft) 1 Lead Retrieval Scanner 1 Imprinted Sign 1 Small Trash Can 2 Chairs

Note: Additional Booth Spaces include all of the above plus extra tables/chairs, if needed. For those with a double space or more, one additional lead retrieval unit will be provided, on request, with no additional fee, See Box 10 below

Check appropriate boxes below or indicate the number of items needed plus total ($) amounts paid. 1

Single Booth

2

$475

Check box for single booth provisions listed above

$

Double Booth $695

Check box for single booth provisions plus extra table, if needed

$

3

Triple Booth

$895

Check box for single booth provisions plus extra tables, if needed

$

4

Quad Booth

$1095

Check box for single booth provisions plus extra tables, if needed

$

5

Bag Sponsor Reg-Exhibitor $175 Check box to have your materials distributed to participants

$

6

Bag Sponsor Non-Exhibitor $375 Check box to have your materials distributed to participants

$

7

Session Sponsor $275/$475 gift item/brochure 550 general session chairs

$

8

Leadership Sponsor $575/$775 gift item/brochure 550 leadership session chairs, verbal/slide/ad

$

9

Lead Sponsor $4,500 Call Randy Johnson at 214-502-7942

$

10

Additional Reps beyond 3 per Booth Space $75 each Write # in box to left--Limit 2/Space

$0

11

Additional Lead Retrieval Unit (one) With a double booth space or more — Check box to left

$

12

Additional Electrical Outlet $85 each Check box for an extra outlet

$

13

Add $50 Late Fee If registering after August 31— Check box to left

$

MAIL or SCAN/EMAIL THIS FORM & REGISTRATION FEE c/o Randy Johnson, 5717 Galaxie Road, Garland, TX 75044 972-530-0554 (H), 214-502-7942 (C), [email protected]

Total

$

Office Use…

PAYMENT BY CHECK— Payable to Baptist Executive Board or PAYMENT BY CREDIT CARD - Visa, Master Card, Discover, Amex - Must Use Credit Card Form

Form# ________________

Make Your Booth Selection — Indicate 1st, 2nd, 3rd choices on Exhibit Hall Map

Date Rcvd: _____________

Booth# ________________