Please print, complete and mail the following form to PCRIA to apply as a Vendor / Presenter / Sponsor for the 2005 Annual Seminar in Birmingham, Alabama. Vendor / Presenter / Sponsor applications are subject to the approval of the PCRIA Board of Directors.
Name:________________________________________________________
Title:_________________________________________________________
Company:_____________________________________________________
Address:______________________________________________________
City:_________________________________________________________
State:_______________ Zip:_______________ Phone:__________________
Email:________________________________________________________
Select from the following:
____ Vendor / Exhibitor Table $375
____ Full Vendor / Exhibitor Booth $450
____ Vendor / Exhibitor Presentation $775
____ Special Break Sponsor $150
____ Hospitality Suite Sponsor $700
____ Silver Standard Conference Sponsor $1000
____ Gold Standard Conference Sponsor $1700
____ Platinum Corporate Sponsor $4000
____ Web Advertisement Only $500
Mail Application & Check / Money Order
payable to PCRIA to:
PCRIA, PO Box 661164, Birmingham,
AL 35266
Fax Application to: 205-791-6235
Contact President Paul Logan at 205-706-2303 with any questions.