| Primary Contact's First
Name: |
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| Primary Contact's Last Name: |
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| Primary Contact's Title: |
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| Primary Contact's Org. Name: |
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| Primary Contact's Mailing Address: |
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| Primary Contact's City, State,
Zip: |
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| Primary Contact's Phone: |
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| Primary Contact's Fax: |
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| Primary Contact's E-mail: (required) |
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| Choose your Exhibitor category: |
N.C. State Government Agencies
$445.00
(Limit one space per agency includes two registrations and lunches)
Non Profit Organizations
$545.00
(Includes two registrations and lunches)
For Profit Businesses
$645.00
(Includes two registrations and lunches)
Additional Table Fee
$345.00
(Maximum total number of tables per exhibitor is 2.)
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| You will be contacted by email to arrange for your complimentary registrations, electricity needs, and exhibit services details. Or, please call Kelley McCarter at 919-515-9563. |
TOTAL REGISTRATION PAYMENT:
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Your Payment Method: |
Online, secure payment with major credit card (AMEX, Visa, Mastercard, Discover)
Check payable to "NC State University" mailed in with copy of this form.
Major credit card entered by hand after printing this form, then mailed or faxed.
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Click the SUBMIT button below to go to the payment webpage.
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