18TH ANNUAL NPN PREVENTION RESEARCH CONFERENCE by HC120915042020

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									                                                                                        14th Annual Native Diabetes Prevention Conference
                                                                                                          Application and Contract for Exhibit/Vendor Space
                                                                                                                        Eldorado Hotel & Spa – Santa Fe, NM
                                                                                                                                          June 13 - 17, 2011
                                                     Please note that space is limited to 15 exhibits and assignments will be made on a first-come, first-served basis.
                                                       In order for us to process your application, you must complete all sections of this form. The information, exactly as it
                                                             appears below, will be printed in the 14th Annual Native Diabetes Prevention Conference Program Guide.
                                                                                       All applications are subject to committee approval.

                                            The University of Oklahoma is an equal opportunity employer. Printed at no cost to Oklahoma taxpayers.

Registration and Contact Information                                                                   number of persons from your organization wishing to attend the conference exceeds the
Full Name                                                                                             number of tables purchased by your organization, those additional persons will need to fill
                                                                                                     out the participant registration form and pay the $350 regular or $450 late/onsite registration
First Name for Name Badge
                                                                                                                                            fee per participant.
Organization                                                                                                                         Special Meal Request
Address                                                                                                                     Vegetarian Meal          Vegan Vegetarian Meal
Address
City            State          Zip                                                                                                            Payment
Phone                2nd Phone                                                                                             Total Tables              Total Fees $
Fax
E-mail                                                                                                                             Purchase Order
Website:                                                                                                      {Copy of purchase order or letter of authorization required}
Secondary Exhibiting Person (only when paying for 2 or more tables)                                                                               Check
Full Name
First Name for Name Badge                                                                                                                     Credit Card
E-mail                                                                                                                   Visa        MasterCard           Am Ex          Discover

Representative to receive exhibit information if different from person(s)                                                   Name on Credit Card
staffing exhibit on-site                                                                                            Credit Card No.            Exp. Date
Name                                                                                                                        Electronic Signature
Phone
Email                                                                                                                  Payable to: “The University of Oklahoma”
                                                                                                                                    Fein 73-6017987

                           Requirements for Display:

                         Table Top Display or        Floor Display                                   Agreement: Applications will not be accepted without payment. Processing of
                                                                                                     your payment does not constitute acceptance into the show nor guarantee space
                            Dimensions of your display:                                              availability. Not withstanding anything else in this agreement, if the exhibitor is not
        Length                 Width               Height                                            accepted or space is not available, the exhibitor fee will be refunded by the
                                                                                                     University of Oklahoma. Aii will not knowingly accept exhibitors that discriminate
                                 Require Internet Access                                             on the basis of ethnic group, race, religion, gender, sexual orientation, age, record
                          (Additional charge assessed by Hotel)                                      of public offense, and/or disability. All applications are subject to committee
                                                                                                     approval.
                                    Require Electricity                                                 By checking this box, our company adheres to and abides by the University of
                          (Additional charge assessed by Hotel)                                      Oklahoma’s policy on non-discrimination. We hereby make application for exhibit
                                                                                                     space at the Native Diabetes Prevention Conference. We agree to abide by the terms
                                   *****Important! *****                                             and conditions set forth by American Indian Institute (Aii).
Arts and crafts booths are competitive. You must send photos (via email, fax or mail)                Electronic Signature:
of your arts and crafts to apply for a booth. Only those selected by our committee will
      be registered for conference. We limit the number of vendors based on our
 attendance. No onsite registration. For more information, contact Carol Shields (see                 Special needs: The College of Continuing Education and the University of Oklahoma are
                                   contact info below).                                              committed to making their activities accessible to persons with disabilities or special needs.
                                                                                                                    If you have any special needs or inquiries, please contact:
To help us in assigning booth locations, please list names of competitors you do not
                                  wish to be near:
                                                                                                                                American Indian Institute
                                                                                                                              1639 Cross Center Dr., Rm 205
                                                                                                                                Norman, Oklahoma 73019
                           Exhibit Area Fees                                                                           Tel: (405) 325.4127 - Fax: (405) 325.7757-
          Informational Exhibitors: $400(due by May 15, 2011)                                                                  chelsea-southerland@ou.edu
          Arts and Craft Exhibitors: $350 (due by May 15, 2011)                                               Please e-mail, mail, or fax registrations to Chelsea Wesner.
                     Additional Tables: $150 Each

  Purchase price of each table includes: Conference registration (conference materials,
conference meals, and access to conference workshops) for one person. Please note: if the

								
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