2010 PSRC Conference in the Capital Vendor Registration

Please complete this form to register as a corporate sponsor for the above named event. Please NOTE that punctuation will not be accepted in this form.

1. Enter Your Company Name
2. Name of 1st Sales Representative working at the booth (included in SILVER LEVEL sponsorship). NOTE: Please include title & credentials if you want them to appear on the name badge.
3. Name of 2nd Sales Representative working at the booth (included in SILVER LEVEL sponsorship). NOTE: Please include title & credentials if you want them to appear on the name badge.
4. Name of 3rd Sales Representative working at the booth (included in GOLD & PLATINUM LEVEL sponsorships only). NOTE: Please include title & credentials if you want them to appear on the name badge.
5. Name of 4th Sales Representative working at the booth (included in PLATINUM LEVEL sponsorship only). NOTE: Please include title & credentials if you want them to appear on the name badge.
6. Name of Person In Charge of Booth
7. Phone Number (cell) for Person In Charge of Booth
8. Email Address for Person In Charge of Booth

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