NAHUC EDUCATION CONFERENCE
Tables for NAHUC Chapters
Exhibits
Chapter Name: ____________________________________________________________
Contact Person: ___________________________________________________________
Address: ________________________________________________________________
City, State or Province, and Zip or Postal Code: ___________________________________
Phone number: _____________________ E-mail:_______________________________
The cost of an exhibit is $25.00 per table (U.S. Dollars). Fee waived for chapters for conference 2012.
I agree to take full responsibility for setting up and removal of exhibit and hold NAHUC harmless for any loss incurred.
Signature:________________________________________ Date:____________________
____Check
or money order payable to NAHUC enclosed
____Charge my: _____Visa _____ Master Card
Card #:__________________________________________ Exp. Date:________________
Signature (for credit card approval) _______________________________________________
Mail to: (Must receive by July 1, 2012):
NAHUC Program Committee
Fax: 815-633-4438
FOR NAHUC USE ONLY
Date received_________________________ ______ Approved
Amount $ received:_____________________ ______ Disapproved
Date reply sent:________________________