3rd Annual Oregon Whole Child Summit Exhibit Request Form

Exhibitor Information

Please complete the following form to reserve your space to exhibit at the 3rd Annual Oregon Whole Child Summit. You will be contacted shortly after submitting to confirm your spot as an exhibitor.

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* 1. Name of your organization

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* 2. Brief description of your organization

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* 3. Contact Information:

Name:

Company:

Address:

Address 2:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

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* 4. Representative at the conference (up to two):

Rep 1 Name:

Rep 1 Email:

Rep 1 Cell:

Rep 2 Name:

Rep 2 Email:

Rep 2 Cell:

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* 5. My booth requires:

Electricty

Internet

Other (please specify):

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* 6. Please submit your logo for promotional purposes

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

The $500 exhibit fee includes skirted 8' table.

Upon completing this form, an invoice will be processed and mailed to the address you provided above. You will receive an initial confirmation email with set up/tear down times, as well as additional information regarding logistics. A final confirmation with a pre-conference attendee list will be sent prior to the conference. If you have any questions, please contact Meghan Cusick Olson at meghan@cosa.k12.or.us