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Exhibit Name (Maximum 35 Characters) Booth Number(s) Sales Rep_______________________________ _____________ _________

Exhibit Description (Maximum 35 Characters)_________________________________________________________

Contact Person______________________________________________

Mailing Address_____________________________________________

City ______________________State ___________ Zip ____________

Shipping Address (If Different From Above)

_________________________________________________________

City ______________________State ___________ Zip ____________

Telephone Number(s)

(Day)_______________________ (Evening)_______________________

(Fax)_________________________ (Cell) _______________________

E-Mail Address_____________________________________________

List ALL products or services to be exhibited.
(Be complete—you may be limited to items listed.)

_________________________________________________________

_________________________________________________________
List Multi-Level or Network Marketing company(s) you will be representing.

_________________________________________________________