Exit this survey >> 2021 LSBA Exhibitors Request Form Please complete the Exhibitors Form Survey and mail payment by Friday, February 12, 2021 Question Title * 1. Name of Exhibitor Question Title * 2. Company Address Question Title * 3. Company Phone Question Title * 4. Email Question Title * 5. Contact Person Question Title * 6. Website Question Title * 7. Do You Require Electricity At Your Booth? ($40 Fee) Yes No Question Title * 8. A payment of $140 (with electricity) was mailed to the Department of Member Outreach and Diversity. Yes No Question Title * 9. A payment of $100 (without electricity) was mailed to the Department of Member Outreach and Diversity. Yes No Question Title * 10. Nametag Information (for those attending the CONCLAVE) 1 2 3 4 Question Title * 11. If you understand and agree to the terms and conditions to exhibit at the 2021 Conclave, please enter your Company Name and Company Representative below. Company Name Company Representative (please type name) Done!