Rheumatology Winter Clinical Symposium - Exhibitor Registration Form

Exhibitor Registration Form

* Denotes Required Field

* Company Name:

* Company Address:

* City:

* State:

* Zip Code:

* Phone:

Fax:

* Email:

* Confirm Email:

* Contact Person:

* On-Site Contact Person:

* Company Name (as to appear on printed materials - one line):

Exhibitor Fees

Exhibitor Company
Fee
(before 9/15/08)
Fee
(after 9/15/08)
Total Fee

$1800
$2000

Exhibit Personnel

First and Last Name
Fee
Total Fee

Complimentary

$300

$300

Grand Total

NOTE: Exhibitors are invited to all meeting sessions and social functions.

Remarks/Comments:

Method of Payment:

CHECK: payable in USD to HTC International AMEX VISA MASTERCARD

Card Number: Exp Date: CID:

Name on Card:

All checks must be mailed to: HTC International , 333 North Michigan Avenue, Suite 1820, Chicago, IL 60601
312-263-1007 Phone • 312-263-0077 Fax • htcintl_info@htcintl.com Email • www.r-w-c-s.com

Contract Agreement:

We/I agree to pay the total fee of $1,800 USD ($2,000 USD after September 15, 2008). We/I agree to abide by all regulations set forth in the accompanying brochure which is made part of this contract, and to all conditions under which exhibit space in the Wailea Marriott Resort is leased to Rheumatology Winter Clinical Symposium. No refund of any deposit will be allowed for voluntary cancellation after November 30, 2008).

Administrative Office:
Rheumatology Winter Clinical Symposium 2008
41 East Lipoa Street, Suite 21 Kihei, HI 96753

Contact:
Phone 858-385-0785 Fax 858-683-2027
Email information.services@r-w-c-s.com