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2019 MACA Summer Conference Exhibitor Registration
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2019 MACA Summer Conference Exhibitor Registration
First Name
*
Last Name
*
Email
*
Title
*
Address 1
*
Address 2
City
*
State
*
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Zip Code
*
Company
*
Business Phone
*
Days Attending
*
July 14, 2019
July 15, 2019
July 16, 2019
July 17, 2019
July 18, 2019
Please choose a sponsorship level
*
- Select -
Gold ($1500)
Silver ($1000)
Bronze ($500)
Representative 1
*
Representative 1 Email
*
Representative 2
Representative 2 Email
Representative 3
Representative 3 Email
How many additional Representatives would you like to register?
- None -
1
2
3
4
5
Extra Representative 1
*
Extra Representative 1 Email
*
Extra Representative 2
*
Extra Representative 2 Email
*
Extra Representative 3
*
Extra Representative 3 Email
*
Extra Representative 4
*
Extra Representative 4 Email
*
Extra Representative 5
*
Extra Representative 5 Email
*
Will you need electricity?
*
Yes
No
Special Requirements
Please use the space below to provide additional details
We agree to abide by the Exhibitor Rules and Regulations that are included as part of this prospectus for the 2018 Mississippi Assessors and Collectors Annual Conference and are made a part of this contract by reference and fully incorporated herein.
*
We agree to abide by the Exhibitor Rules and Regulations that are included as part of this prospectus for the 2019 Mississippi Assessors and Collectors Annual Conference and are made a part of this contract by reference and fully incorporated herein.
Payment Type
*
Mail Check
eCheck
Make Checks Payable to:
Extension Center for Government and Community Development
Attn: MACA Annual Convention
Box 9643
Mississippi State, MS 39762
Total
*
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