ASC 2010 Fall Convention Exhibit Booth Contract

Note: This form is a booth contract that registers your company for an exhibit booth only - to register for the convention, exhibitors must submit a separate convention registration form (via online, fax or mail) for each individual expo participant who wishes to attend.

Please note that convention registration gives individuals access to the educational sessions, meal functions and receptions. Expo only attendees do not have access to any convention event, but the expo.

For questions regarding convention registration or the expo, contact Malinda Armstrong at (301) 986-9700 ext. 106.

All fields denoted by * are required.
Contact Information: Provide the name of contact person to receive ASC correspondence regarding booth(s).
*Name	Mr. Ms. Mrs. Dr.
*Title
*Company
*Address Line 1
Address Line 2
*City
*State/Province
Country
*Zip/Postal Code
*Phone
*Fax
*E-mail	(type "NONE" if you do not have an e-mail address)
I am a first-time exhibitor.
I am interested in sponsorship opportunities. Please contact me.
Exhibit Guide Information: Provide the contact information for the individual to be listed in the Exhibit Guide, which is distributed to all attendees onsite.
The contact person above is also the contact for the Exhibit Guide.
*Name	Mr. Ms. Mrs. Dr.
*Title
*Company
*Address Line 1
Address Line 2
*City
*State/Province
Country
*Zip/Postal Code
*Phone
*Fax
*E-mail	(type "NONE" if you do not have an e-mail address)
Complimentary Booth Personnel: Each exhibiting company is allowed two (2) complimentary exhibit-only personnel representatives per 8' x 10' booth. Additional exhibit-only personnel can be added in the registration fees area of this form at a cost of $195/person. (Please type TBD if you have yet to appoint booth personnel).
*Booth Rep #1 Name:
*Booth Rep #1 Title:
Booth Rep #2 Name:
Booth Rep #2 Title:
Booth Space Request: Please refer to floor plan and indicate booth choices.
*1st choice:
*2nd choice:
*3rd choice:
Booth Identification:
*Company Name:
*City/State/Province:
Other Companies: Please identify the companies you would prefer not being located next to. Separate company names with a comma.
Other Companies:
*REGISTRATION FEES: Note: In order to access the member rate, you must login. If you do not have your member login and password, please contact Malinda Armstrong. One (1) 8' x 10' Booth $890 (ASC Member) $1735 (Nonmember)   Two (2) 8' x 10' Booths $1780 (ASC Member) $3470 (Nonmember)   Additional Booth Personnel: The fee for each additional exhibit-only representative is $195: $195 - One (1) additional booth rep Additional Booth Rep #1 Name:   Additional Booth Rep #1 Title:     $390 - Two (2) additional booth reps Additional Booth Rep #1 Name: Additional Booth Rep #1 Title:    Additional Booth Rep #2 Name: Additional Booth Rep #2 Title:      TOTAL $
Payment All payments must be made in U.S. dollars drawn on a U.S. bank. *Payment (check method): VISA       MasterCard       AMEX *Credit card number: (Input credit card number with no dashes) *Expiration date:       (MM/YYYY)   Cancellation Policy: No refunds will be granted after September 17, 2010. Liability Disclaimer: The Adhesive and Sealant Council (ASC) claims no liability for the acts of any participant at this meeting, nor for the safety of any person participating in, or in transit to or from this event. ASC reserves the right to cancel any function without penalty. The total amount of any liability of ASC, in the event of cancellation, will be limited to a refund of the registration fee.
By clicking the submit button, you agree to the following Declaration of Acceptance: "We hereby accept the terms and conditions of participation in the ASC Exposition as outlined in the 'Expo Rules' section of the Exhibitor Prospectus."
Press the "Submit" button to send your request. PLEASE CLICK SUBMIT ONCE (Print this page for your records.)