ASOR 2008 Annual Meeting Exhibit Registration Form

2008 ASOR ANNUAL MEETING

EXHIBITOR REGISTRATION FORM

* Indicates required field

Name of Company*

Address*

City*

State*

Zip (and Country if outside USA)*

Name of Contact Person*

Telephone Number*

Fax Number

E-mail Address*

Name of Representative(s) (for name badges)

Number of FULL tables (6' x 30") at $200 each you wish to reserve

Half of a table (up to 10 titles) for $150

Payment
Credit card type: Visa Mastercard
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Please bill my credit card in the total amount of: $ *

Card Number (please enter 16 digits without spaces):*

Expiration Date:(mm/yy)*

Name on Card:*

Billing Zip or Postal Code if different from above:

Comments or special instructions:

Name of Company*
Address*
City*
State*
Zip (and Country if outside USA)*
Name of Contact Person*
Telephone Number*
Fax Number
E-mail Address*
Name of Representative(s) (for name badges)
Number of FULL tables (6' x 30") at $200 each you wish to reserve
Half of a table (up to 10 titles) for $150

Card Number (please enter 16 digits without spaces):*
Expiration Date:(mm/yy)*
Name on Card:*
Billing Zip or Postal Code if different from above:
Comments or special instructions: