Exhibit Reservation Form and Contract

Exhibit Reservation Forms must be received by Friday, March 15, 2013.

• 8' X 10' pipe and drape booth with 8' backwall and 3' sidewall, one 6' skirted table,
  two chairs, one wastebasket, and ID signage
• Exhibit pass for the conference for one individual
• Recognition in the conference program

Company/Organization Name:
(as it should appear in the program and on exhibit signage)

The Primary Contact will receive all correspondence from WIN and GES regarding exhibits. The Primary Contact is responsible for submitting to WIN the name and contact information of the exhibit representative no later than March 15, 2013. Only one exhibitor pass is included with exhibitor registration. Additional exhibitors must register for the conference using the online conference registration form, available on the WIN website in early 2013.

Primary Contact First Name:

Last Name:

Email:

Address:

City:

State (if US):

Postal Code:

Country:

Phone:

Fax:

Company/Organization Web Address:

Brief description of product/services to be displayed:

Select your company/organization type:

Prices do not include electrical services, which will be outlined in the Exhibitor Service Manual.

WIN Member Agency: Complimentary Booth

Corporation, Publishing Company, For-Profit Organization: $750.00

School of Nursing, Federal Agency, Nonprofit, Small Nurse-Run Business: $600.00

Reserve your Booth:

Please refer to the numbered exhibit hall floor plan and enter your preferences below:
Member Agencies of WIN, receiving complimentary booths, may select from booths 9 through 33.
Exhibitors purchasing booths may select from all booths.

1st Booth Preference

2nd Booth Preference

No Booth Preference

The individual agreeing on the behalf of the Exhibitor warrants that he/she is authorized to do so.

I have read and accept the Exhibitor Terms and Conditions.

Payment options: Credit Card A check will be mailed to WIN

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Zip:

Phone Number:

Email:

Amount:$

Card Number:

Expiration Date:
(mm/yy)

Card Holder Name:

You will have a chance to review your information before you finish.

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