Vendor Exhibit Application

Vendors are invited to apply for exhibit space within the educational conference room. Space will be assigned on a first-come, first-serve basis. Cost per display table is $475 when application and payment are submitted before September 1, 2010 at 5:00pm. Applications received after Wednesday, September 1, 2010 will cost $550.

Conference Topic:     Spokane Pharmacy Association Annual Awards Banquet

Conference Date/Location:   Tuesday, October 12, 2010, Georgian Room, 1002 West Riverside, Spokane, WA,  6:00pm-9:00pm

This form may be filled in on-line and printed or submitted electronically.

Number of Display Tables:    Is an electrical outlet required? Yes   No

Company Name:

Contact Person:

Street:

City:    State:    Zip:

Work Phone: Invalid format.Please enter phone number Fax: 

E-mail: A value is required.Invalid format.  Verify Email: A value is required.The values don't match.

Representative #1:    Representative #2:

Rep #1 Dinner?  Yes   No           Rep #2 Dinner? Yes   No

 

      

A confirmation letter will be mailed with further information, including set-up times, and an invoice number for on-line payment.

Make checks payable to: Spokane Pharmacy Association - Tax ID# *91-1999051

Mail forms to: Spokane Pharmacy Association, P.O. Box 2591, Spokane, WA 99220  

On-line payment:      http://spokanepharmacy.org/advertising.html
An on-line payment may be made after form is submitted and invoice number assigned.

Fax forms to: 509-624-4330

*SPA is a Washington non-profit corporation registered with the IRS under § 501(c)(6)

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SPA Use Only: Date Received:___________        Invoice #______________