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Final Draft Dulles Regional Chamber Health Fair 2011 Hyatt Dulles

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Final Draft Dulles Regional Chamber Health Fair 2011 Hyatt Dulles Powered By Docstoc
					Final Draft                                         Dulles Regional Chamber Health Fair 2011
                                                                  Hyatt Dulles Hotel
                                                   2300 Dulles Corner Blvd., Herndon, Virginia 20171
                                                        September 7, 2011, 9:00 AM – 2:30 PM
                                                        Deadline for vendor spaces is September 1, 2011.
        Vendor Table                                      Early bird price deadline is August 15, 2011.
        Reservation Form                   Vendor space is limited. Reserve early to ensure your vendor table.



        Company/Organization name:
        Name of representative(s) staffing your vendor table (as name should appear on vendor badge):

        1st representative: _____________________________________________________________________

        2nd representative: _____________________________________________________________________

        Company contact:                         ____                    Phone:

        Address:

        Email:

        Vendor Table Price:                By 8/15/2011            After 8/15/2011
        Chamber member                     $100                    $135
        Non-chamber member                 $150                    $185
        Non-profit chamber member          $35                     $135

        Will you need electricity?     ___ Yes            ___ No

        Newsmaker Luncheon Tickets
         Member $45        # of Tickets needed
         Non-Member $60 # of Tickets needed

        Total for vendor tables:       $ _________________
        Total for luncheon tickets:    $ _________________
        Total amount enclosed:         $ _________________

        Payment must be received to insure that a table will be reserved for you. Make check payable to the
        Dulles Regional Chamber of Commerce and send to the Chamber at 3901 Centerview Drive, Suite R,
        Chantilly, VA 20151. Credit card payments can be made by calling the Dulles Regional Chamber office
        571-323-5300.

        Please sign and date below that you have read the Application Terms and Conditions related to the date
        of this event.

        X                                                                X




                                                                                                 Revised 7-20-11

				
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