Business Name *

Maximum number of characters: 40

Name of Contact *

Maximum number of characters: 30

Contact's Business Title *

Maximum number of characters: 50

Type of Business *

Maximum number of characters: 30

Business Phone *

Maximum number of characters: 15

Cell Phone

Maximum number of characters: 15

Fax

Maximum number of characters: 15

Email Address *

Maximum number of characters: 50

Location Address, Town, State, Zip *

Maximum number of characters: 60

Mailing Address, Town, State, Zip

Maximum number of characters: 60

Website Address

Maximum number of characters: 30

How Did You Hear About EXPO? *

-- Please Select --Email Newspaper / Magazine Brochure GOTCC Website Outdoor Sign Family / Friend Other Internet

Detailed Description for EXPO Program (up to 50 words). *

Maximum number of characters: 1000

Do you want to upgrade to a 1/2 page B&W ad in our program (your listing is free and it will remain)? *

• Upgrade to 1/2 Page B&W Ad +$50.00
• No thanks

I would like to donate a door prize *

• Yes
• No

Names of up to 3 people for name badges *

Maximum number of characters: 100

Requirements - Note: Electricty will be provided on a first-come first-serve basis, though we do not expect a problem, we will do out best to accommodate your needs. We do not provide extension cords or duct tape. Note: Table size: We will do our best to

6' Table and 2 chairs 8' Table and 2 chairs Electricity Space for Large Back Drop

Please let us know if you have any secial needs *

Maximum number of characters: 200

Please let us know if you have any secial needs *

Maximum number of characters: 200

* Required Fields