2012 Trade Show Exhibition Application

If you would like to mail your application in, please download the application page (pdf file)
-->click here

The 2012 AHCA Annual Conferences Trade Shos

Company Name:
Address:
Address 2:
City:
State:
Zip:
Phone:
Fax:
Email:
Please Mark Appropriate Box:  
NEW VIP Booths for Annual Conference
VIP Booth - Annual Conference (MEMBER) Annual Conference ($3,000.00)
VIP Booth - Annual Conference (NonMEMBER) Annual Conference ($3,400.00)
Business Affiliate

Annual Conference ($1,300.00)
Non-Members

Annual Conference ($1,600.00)
Describe services/products displayed:
Show Contact Name:
Title:
Contact Email Address:
Onsite Names for your Booth*:
Name1:
Email1:
Name2:
Email2:


 
Booth (Annual Conf.) We Want to Reserve:

Annual Conference Booth (see layout):

Note: If a Booth #is not listed, it has been reserved. VIP booths are at the end of the drop down list.

Please reserve with the following abbreviated company name (10 characters or less) .This is to identify your reservation for the ANNUAL CONFERENCE on the layout form.

 
*Exhibitor fee includes all food and beverage for up to two (2) people. There will be an additional cost for more than two representatives at your booth. AHCA reserves the right to reassign exhibit space as necessary.

To stop automated spammers from submitting on this form,
we need you to enter the text conference2012 (exactly as shown) into the box below:

 


©2009-11 Arizona Health Care Association. All rights reserved.
Web Development Design Media Pros