2003 Booth Form

Company _____________________________________________________________

Address ______________________________________________________________

City ________________________________ State __________ Zip Code ___________

Telephone ________________________ Facsimile ___________________________

Contact Name _________________________ Title _______________________________

E Mail Address ____________________________________________________________

List Exhibitors you do not wish to be near______________________________________

______ 8′ x 10′ space(s) @ $675.00 = $ __________
Full payment is required with this form and due no later than April 14, 2003
METHOD OF PAYMENT – NO PURCHASE ORDERS WILL BE ACCEPTED

___ VISA ___ AMERICAN EXPRESS  ___ MASTERCARD ___ CHECK*
*Make Checks Payable to: MICHIGAN NENA

ACCOUNT # ____________________________ EXPIRATION DATE: _______________

NAME ON CREDIT CARD ___________________________________________________

AUTHORIZED SIGNATURE ________________________________________________

All exhibit space will be in the Hotel withConference Sessions. Vendor time is “exclusive” and includes areception on Monday evening and a continental breakfast on Tuesday morning.