CONFERENCE EXHIBITOR REGISTRATION FORM
On-Line Registration (preferred with Credit Card) Fax to: (214) 341-95229522 (with Credit Card) or Mail with Check to: IHI, Conference Registration 10875 Plano Rd., Suite 123, Dallas, TX 75238 See Conference Information at www.intestinalhealth.org/Taosevent
Special Discounted Rates for New Mexico!
This form is for New Mexico Conference Exhibitor Registration. You may register more than one person on this form if the same credit card is used for all persons. If not, a separate registration form is required. To register by telephone, please call (804) 247-1655. st Exhibitor Booth Package Exhibitor Full Registration Package for 1 Exhibitor Exhibitor Booth Package includes: Includes Booth Package and Full Registration for the st 1 Exhibitor to an Exhibitor Full Conference One Exhibitor Badge Registration and includes: 10’ by 10’ Booth Access to all Educational Programs 8’ Skirted Table Welcome Reception Thursday Night 2 Chairs Saturday Night Banquet Waste Paper Basket Lunches and All Breaks – 2 ½ Days 1 Exhibitor Meal Package (2 lunches, 4 Special New Mexico rate is just $600 for Booth and snacks) Full Registration. A 2nd Exhibitor Full Registration Special New Mexico rate is $300. A second fee is $300 (same price as Attendee Full Conference). Exhibitor Registration fee is $174 (2 lunches, 4 snacks) Additional Tickets: _____ Thursday, April 4, 2008 Welcome Reception @ $45.00 Check One: First Name: Company Name: Address: City: State: ZIP: Phone ____ Exhibitor Booth Package @$300 _____ Saturday, April 6, 2008 Banquet @ $60.00 ____ Exhibitor Full Package Upgrade @ $600 Last Name:
Email Address (required for confirmation): Banquet Meal Special Needs: ____ None Second Exhibitor (Check One): _____ Second Exhibitor Booth Package Registration @ $174 _____ Second Exhibitor Full Registration @ $300 Name of Second Exhibitor: Email of Second Exhibitor: Banquet Meal Special Needs: ____ None Phone ____ Vegetarian _____ Kosher ____ Vegetarian _____ Kosher
Note: By providing your e-mail, you grant IHI permission to contact you via e-mail regarding your registration and updates on the "The Higher Truth of Health" Conference. Name of person who contacted you: Method of payment: ___Master Card ___Visa ____Check or money order enclosed (Please make payable to: Intestinal Health Institute in U.S. dollars drawn on U.S. bank.) Credit Card Number: Name On Card: Signature: Total Amount Due: $ PLEASE NOTE: Registration will not be processed without payment or if submitted with declined or invalid credit cards. COURTESY NOTE: “The Higher Truth of Health” is a non-smoking conference. Also, out of respect for our chemically sensitive patrons, we ask that no perfume, cologne, hair spray or other perfumed products be worn at the conference. Thank you. REFUND POLICY: Refunds (less a $50.00 processing fee) will be given to registrants who cancel by 5:00 p.m. on Friday, March 14, 2008. No refunds will be made after that time. DISABILITY ARRANGEMENTS: If special arrangements are required for anyone with a disability, please contact us at (804) 247-1655. NOTE: You may transfer your registration to another person at any time. Exp Date: 3 Digit SSV Code: Billing Zip Code: Date: