The Parent Empowerment through Education for the Lifespan of Children with Disabilities Conference Display Form

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* 1. What is your contact information

Name:

Organization:

Title:

Address:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

Website Address (if applicable)

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* 2. Description of product(s) to be displayed:

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* 3. Special needs for exhibit space

Applicants will be notified by August 17, 2013 that application was accepted.
Set up is between 6pm-9pm on October 8, 2013 or between 7am-8am on October 9, 2013.
For questions contact SPEAKS at (906) 635-8984.