EXHIBITOR REGISTRATION FORM

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Phoenix Convention Center Phoenix, AZ EXHIBITOR REGISTRATION FORM EXHIBITOR EMPLOYEE REGISTRATION: Exhibitors shall be provided registrations/badges for their employees or manufacturer representatives and/ or agents (referred to herein as "Employee Badges.") Exhibitors are allotted three Employee Badges for a 10' x 10' booth. All other exhibitors are allotted two Employee Badges per 100 square feet of paid exhibit space. A list of all exhibitor personnel who are provided Employee Badges shall be provided by exhibitors to BCMC 2009 two weeks in advance of the show. Employee Badges shall be worn by such personnel at all BCMC 2009 functions. The person whose name is on the Employee Badge is responsible to pick up such badge and must show identification, due to heightened security that is required now at all tradeshow sites. Exhibitors are not allowed to issue or assign Employee Badges to non-exhibitor personnel, component manufacturers or other show attendees. Children over the age of 14 may be admitted to the exhibit area during exhibit hours only with prior approval from the Committee. AT NO TIME ARE CHILDREN ALLOWED DURING EXHIBITOR MOVE-IN OR MOVE-OUT. CANCELLATION POLICY: Cancellations must be made in writing on or before August 25, 2009 and will entitle registrants to a partial refund; $75 of each registration fee is nonrefundable. No refunds will be issued after August 25, 2009, including "no shows." Substitutions of exhibiting company personnel are allowed. Thru 8/25 MEMBER NON-MEMBER SPOuSE $165 $250 $120 After 8/25 $190 $275 $120 _________________________________________________________________________ COMPANY CONTACT _________________________________________________________________________ COMPANY _________________________________________________________________________ ADDRESS _________________________________________ /__________/_____________________ CITY STATE ZIP ___________________________________________ /_____________________________ PHONE FAX ___________________________________________ /_____________________________ EMAIL WEBSITE _____________________________________ SIZE OF BOOTH (Sq. FT.) Please indicate EXHIBITOR PERSONNEL REGISTRATION (EPR) (not for spouse tour registrant) or use the appropriate fee for each registrant. Submit payment with this form. use one page per location. I AM ALSO REGISTERING FOR GOLF. SEE ATTACHED FORM. PLEASE TYPE OR PRINT INFORMATION CLEARLY. 1. __________________________________________________________________ EMPLOYEE (FIRST/LAST) ___________________________________________________________________________ FAMILIAR/BADGE NAME (IF DIFFERENT THAN ABOVE) ___________________________________________________________________________ NAME OF COMPANY WHERE THIS PERSON WORkS (If different than exhibiting company) LIST THEIR COMPANY NAME ON THEIR BADGE LIST OuR COMPANY NAME ON THEIR BADGE SPOuSE TOuR EPR FEE _________________ 2. __________________________________________________________________ PAYMENT INFORMATION: CHECk ENCLOSED (PAYABLE TO BCMC) CHARGE MY AMERICAN EXPRESS MASTERCARD VISA EMPLOYEE (FIRST/LAST) ___________________________________________________________________________ FAMILIAR/BADGE NAME (IF DIFFERENT THAN ABOVE) ___________________________________________________________________________ NAME OF COMPANY WHERE THIS PERSON WORkS (If different than exhibiting company) LIST THEIR COMPANY NAME ON THEIR BADGE LIST OuR COMPANY NAME ON THEIR BADGE SPOuSE TOuR EPR __________________________________________________________________________ CARD NuMBER 3. FEE _________________ __________________________________________________________________ _____ / _____ / _____ EXP. DATE __________________ VERIFICATION CODE __________________________________________________________________________ CARDHOLDER (PLEASE PRINT) __________________________________________________________________________ SIGNATuRE Patrons with disabilities should notify BCMC staff at least two weeks prior to the show (9/14/09) so that reasonable accommodations may be made. Cut off date for pre-registration is Friday 9/25/09. If paying by check, please do not fax in this form. RETuRN COMPLETED FORM WITH EACH PAYMENT TO: EMPLOYEE (FIRST/LAST) ___________________________________________________________________________ FAMILIAR/BADGE NAME (IF DIFFERENT THAN ABOVE) ___________________________________________________________________________ NAME OF COMPANY WHERE THIS PERSON WORkS (If different than exhibiting company) LIST THEIR COMPANY NAME ON THEIR BADGE LIST OuR COMPANY NAME ON THEIR BADGE SPOuSE TOuR EPR FEE _________________ TOTAL AMOUNT ENCLOSED $ __________________ All changes to registration orders must be submitted in writing in the form of mail, fax, email or using the online system. Check here if this is a change to a previous registration for BCMC 2009. For Office Use Only: Date Rcd: __________________ DATE INITS BCMC 6300 ENTERPRISE LANE MADISON, WI 53719 Order # __________  Check # _______ _____ ____  Charge DATE INITS LOCID _____________________ Database Verified: _____ ____ Payment processed _____ ____

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