Date of Meeting   Exhibit Dates

Location of Meeting

Exhibit Space

Please indicate the number of spaces you will need for the type of space offered (commercial, governmental, or others)

A. space(s) for commercial companies: $500 each
B. space(s) for non-commercial agencies: $300 each
 
C. There are many agency membership options that include exhibit space. Check them out!

General Information

1. Standard space includes: One 6 foot table with linen and chair(s) (size of exhibit must be contained within this space; additional space may be purchased)

2. Do you need an electrical outlet?  Yes                            No

3. Please specifiy any company or type of company you would like to be near or away from:

Near to:   Away from :

Name and address of representitive who will operate the exhibit:

First Name*:   Last Name*:

Address : Address Line 2:

City: State: Zip:

Phone: Fax:

Other persons who need name tags:

Special Events

We would like to make a donation to help sponsor a portion of the TPHA Program or Sponsor a Social Event:

TPHA Program Social Event

$

Company Contact

Company Name   Company Official

Address Title

City/State/Zip Phone : Fax

Date
Authorized Signature (Esignature or Email Address)