2012 Tradeshow Personnel Registration

1. Trade Show Personnel Registration/Lunch Order/Welcome Reception Registration

Please complete the following to prepare for the personnel working your booth.

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* Exhibitor Information

Name: *

Company: *

Booth Number:

Email Address: *

Area Code & Phone: *

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* Lunch Order: Each exhibit booth is eligible for 2 complimentary lunches. End caps and double booths receive 4. To receive your lunches, please complete this form by January 23. Additional lunches can be ordered for $35 each.

Lunches will be delivered to your booth at 11:00 a.m.

Number of lunches requested (included with booth)

Number of additonal lunches ($35 each)

Number of vegetarian lunches (from total above)

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* Total Amount Due:

Prepayment is required. You will have the opportunity to provide your credit card information on the next page.

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* Trade Show Personnel Name Tags: PowerTest has no set limit of the number of personnel working your booth at the trade show. Name tags will be available at the registration desk.

To ensure delivery of name tags, please submit the form no later than January 23, 2012.

Please list names below - first and last name as it should appear on badge.

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* Welcome Reception Complimentary Registration: Up to 4 booth personnel may attend the Monday evening Welcome Reception at no additional charge. Name badges and reservations are required for this event.

Please list provide the names of the booth personnel utilizing the complimentary registrations for this event - first and last name as it should appear on badge. The deadline to register for this event is January 23, 2012.

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* Additional Registrations for Welcome Reception: You may register additional booth personnel for Monday's Welcome Reception at a fee of $25 each.

Please list provide the names of the booth personnel registering at $25 each for this event - first and last name as it should appear on badge. The deadline to register for this event is January 23, 2012.

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* Total Amount Due:

Prepayment is required. You will have the opportunity to provide your credit card information on the next page.