2005 Convention Exhibitor Application Form

2005 CONVENTION EXHIBITOR APPLICATION FORM

Company: __________________________________________________________________________

Address: _______________________________________________ City: _______________________

State/Region: __________________________ Zip Code: ________________ Country: _____________

Telephone: ____________________ Fax: _____________________ Email: ______________________

Person(s) Responsible For Exhibit At Convention: ________________________________________

Person To Receive Letter Confirming Receipt Of This Application: ________________________

Product/Service To Be Exhibited: _______________________________________________________

___________________________________________________________________________________

List quantity and total cost for each of the following items:
______ Tables at $750 each = $ ___________
______ Electrical Service Request* at $80.00 each = $ ___________
______ Please indicate if you require either telephone or Internet access. If checked, we will authorize the hotel to provide information on cost to your organization. Please do not send any money to the NFB for these services.

*Standard electrical outlet: AC, 110V, single phase up to 20 amps provides 4 spaces to plug into. If your electrical needs cannot be met with the above service, contact the Exhibit Coordinator prior to the convention to order additional service. Within limits of safety and fire regulations, power strips may be run off the outlet(s) ordered.

All applications must be accompanied by the exhibitor's fee in the amount of $750.00 per table and need to be received by Friday, June 3. (We will accept written purchase orders from federal agencies.) If you have requested electrical service, include payment for the cost of the service requested with your payment for space. (Note that the exhibitor's fee covers only the space provided and does not include convention registration for individuals working as exhibitors. Convention registration opens early Sunday morning and remains open throughout much of the convention week.) By return letter we will acknowledge receipt of your application and payment and provide some additional details (e.g. drayage services available) to assist you in planning for our convention.

SEND THIS APPLICATION ALONG WITH THE FEE (S) TO:

EXHIBIT COORDINATOR
NATIONAL FEDERATION OF THE BLIND
1800 JOHNSON STREET
BALTIMORE, MARYLAND 21230

Enclosed for Exhibitor's Fee(s) . . . . . . . . . . . . . . $______________
Enclosed for Electrical Outlet(s). . . . . . . . . . . . . . $______________
Late Fee for applications received and accepted
after June 3, 2005 ($100 per table) . . . . . . .$______________
Total enclosed . . . . . . . . . . . . . . . $______________

Charge to Credit Card #:__________________Exp. Date:_______ Circle: MC / Visa / Discover
Check number: __________________ (Payable to the National Federation of the Blind)