SPONSORS/EXHIBITORS REGISTRATION

Ohio River Basin Consortium for Research & Education

Annual Symposium – October 29-31, 2008 (Pittsburgh, Pennsylvania)

                     

Organization                                                                                                                                                              

 

Address                                                                                                                                                                       

 

City                                                                                          State                            Zip                                           

 

Area Code            Phone                                                          Fax Area Code             Fax Phone                              

 

E-Mail                                                                          Website                                                                                  

 

Official Representative (Person to receive all mailings and information)

 

Name                                                                           Title                                                                                        

 

Address                                                                                                                                                                      

 

City                                                                                          State                            Zip                                         

 

Area Code            Phone                                            Fax Area Code                   Fax Phone                                     

 

E-mail                                                                                                 

 

Booth Staff  (as you want it to appear on name badge)     Name(s)                                                                            

 

SPONSOR

___ Single Booth                                  $1,000.00 or more                     $                                 

___ Additional Table(s)                        $50 each                                    $                       

 

EXHIBITOR

___ Single Booth                                  $400.00                                    $                                  

___ Additional Table(s)                        $50 each                                   $                        

 

TOTAL                                                                                                $                        

 Payment:  Please make the check payable to ORBCRE

 

Siignature                                                                     Date                                             

Send this completed page, payment and other services request to:

Attn: Dr. Tiao  J. Chang

ORBCRE, 147 Stocker Center, Ohio University, Athens, OH 45701