Exhibitor Opportunities
NETWORKING MALL EXHIBITOR AGREEMENT & SELECTION FORM - PART I
Thank you in advance for participating in the 2018 Entrepreneurial Insurance Symposium ! MarketScout will send each exhibitor a receipt confirming acceptance and specific sponsorship benefits according to the prior pages of this document .
_________ Exhibit Booth $ 1,600 _________ Total Attendee Registration ( s ) ($ 430 / attendee ) _________ CIC / CRM Update or Requesting CE Credit-Registrations ($ 430 / attendee )
Grand Total Due for Exhibitors Please make checks payable to MarketScout .
$ ________________________________
Company Name : ___________________________________________________________________________ Contact Name : ________________________________ Title / Position : ________________________________ Phone : ________________________________________ Email : ____________________________________________
Method of Payment : American Express MasterCard Visa Check #:______________ Credit Card #: _________________________________ Exp . Date ( MM / YY ): ____________ CVC #: __________ Credit Card Billing Address : ___________________________________________________________________ City : ________________________________________ State : ______________________ Zip : ______________ Name on Card ( Please Print ): __________________________________________________________________ Signature ( Required ): ____________________________________________ Date : _______________________
Please send completed Exhibitor Agreement & Selection Forms Part I & II to Diahann Doyen by fax at ( 972 ) 934-4299 or email at eis @ marketscout . com . You will receive confirmation once your sponsorship has been approved . Sponsorships are assigned on a first-come , first-serve basis and are non-refundable .
Tel : 972.934.4264 Email : eis @ marketscout . com www . eInsuranceSymposium . com