Teaching aNd Technology13 Institute

BOOTH REGISTRATION FORM
(You must also register for the conference.)
  • Registration is $40 per person in booth.
  • Booth space is free. (In lieu of booth space fees, please plan on providing a door prize(s) or a monetary donation.)
  • Confirmation of your booth space will be sent to you via email after August 1, 2011.
  • For questions contact:
    Anissa Fontenot
    anissa.fontenot@cpsb.org
    PH:  337.217.4120 ext. 1035    		  

 First Name

Last Name

Title

Company

Address

City

State

Zip

Phone

Fax

Email

Web Address

Company Description
(50 words or less)

 (This information will be posted on the "Exhibitors" section of our website www.cpsb.org/tnt)
 
In lieu of a booth fee, we expect each vendor to donate item/items to be given away as door prizes to be given away at the closing session of the conference or a monetary donation.

  I will donate a door prize(s).

  Please list item(s) below that you will donate:

Door prizes can be shipped to:

Anissa Fontenot
1724 Kirkman St.
Lake Charles, LA 70601

  I will make a monetary donation to help defray conference costs.
  Amount:

Make monetary donations payable to:

Region V LACUE
1724 Kirkman St.
Lake Charles, LA 70601

How many people (including the person listed above) will be in your booth:          

Please list the additional (don't include the person listed above) people for your booth:

First Name
 Last Name
First Name
 Last Name
First Name
 Last Name
First Name
 Last Name
First Name
 Last Name