2008 Prehospital Emergency Care and Crisis Intervention
EXHIBITOR REGISTRATION FORM - Nov 19- 22, 2008
Vendor Company Information
Name:
Phone:
Contact Person:
Fax:
Address:
Address (cont.):
City:
State:
Zip Code:
Email:
Payment Options
(Payment by check only)
Check:
Make checks payable to Emergency Medical Services Associates.
Send Checks to:
Prehospital Emergency Care Conference
223 W. Bulldog Blvd., #405
University Station
Provo, UT 84604
Fees
Item Description
Fee
Quantity
Total
10 x 10 Draped Booth
$650 ea.
10 x 20 Draped Booth
$850 ea.
10 x 30 Draped Booth
$1050 ea.
Ambulance Space / Rescue Equipment
$500 ea.
TOTAL AMOUNT DUE: ______________
Note: No exhibitor spaces will be reserved without payment in full. Fees are due at time of registration and before the conference begins. Questions, contact Elle Martin at 801-856-6122, 801-489-5967