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Wyoming Hospital Association
72nd Annual Meeting Application
* The following fields are required.
Organization
(type name as it should appear on Convention materials)
 *
Address  *
City  *
State  *
Zip Code  *
Phone  *
Contact Person  *
E-Mail Address  *
Name & Title of those staffing your booth: (Registration is for two (2) attendees)
Name Title
Name Title
Name Title
Booths will be assigned on a first come, first served basis.
15-20 word description of the product or service of your
organization, for the Exhibitor Listing:
The Exhibit Fee includes two tickets for the Wednesday and Thursday meal functions and socials. [Check all that apply]
  Full Booth Exhibit Fee - $750.00
  Advertising Fee - $300.00
  Sponsorship
  Additional Tickets for Attendees - $100.00 each
[ please list the first and last names of each Attendees in the box below ]
In order to better accomodate our vendors, this section must be completed if you have additional needs, i.e. electrical, Internet access, phone lines, or exhibits larger than the 8x10 allotted space (additional fees may apply). Please describe your requirements below:

Pay Now

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