Trade Show Participation Application: MEDICA 2023

Company/Organization Information

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* 1. Company/Organization Official Name and Contact Information:

Company Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Website *

Phone Number *

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* 2. Company Information:

Year Established

Number of Employees

Three Year Average Revenue

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* 3. Business Type:

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* 4. Industry Sector(s):

Sector 1

Sector 2

Sector 3

Sector 4

Sector 5

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* 5. NAICS Code(s):

NAICS Code 1

NAICS Code 2

NAICS Code 3

NAICS Code 4

NAICS Code 5

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* 6. Company Description:

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* 7. Exportable Products and Services:

Product/Service 1

Product/Service 2

Product/Service 3

Product/Service 4

Product/Service 5

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* 8. State of Texas Business and Tax Information:

Texas Secretary of State Filing Number

Texas Franchise Tax Identification Number (if applicable)

Texas Sales Tax Identification Number (if applicable)

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* 9. Is your company a certified Historically Underutilized Business (HUB) or Disadvantaged Business Enterprise (DBE)?

Yes