/ 2012 VAGP/CAPA REVERSE TRADE SHOW
Wednesday, May 23, 2012, 9:00 am-3:00 pm

HOLIDAY INN KOGER EXECUTIVE CENTER
1021 Koger Center Boulevard
Richmond, VA 23235 /

PUBLIC AGENCY REGISTRATION FORM

PUBLIC AGENCY EXHIBITORS NEEDED

PRE-REGISTRATION IS REQUIRED

Please EmailRegistration Form ASAP to

Please plan to join VAGP and CAPA for another Reverse Trade Show. Don’t miss this great opportunity to network with other public procurement professionals and vendors while growing your vendor outreach efforts. This year’s event will be held Wednesday, May 23rdfrom 9:00 a.m.–3:00 p.m. andwill offer vendor participants the opportunity to register to attend a morning or afternoon Trade Show. Vendors will also be able to attend an educational session. The Event Dining Hall will provide lunch and networking opportunities for public agency representatives and vendor participants.

Public Agencies participating in the Reverse Trade Show will be provided the following:

  • Two (2) FREE event registrations for your agency representatives
  • One (1) Expo Booth, completely set up with pipe/drape, table, two (2) chairs, booth signage, and electrical and Internet access in the booth
  • Access to the Public Agency Break Area (morning and afternoon snacks and beverageswill be provided)
  • Access to the Dining Hall for lunch,provided at no costfor two (2) agency representatives
  • Onsite Parking provided at no cost
  • An opportunity to network with over 500 Vendors AND a chance to win great VAGP/CAPA door prizes!

Section I - Public Agency Registration Information
Public Agency Name
Address
City, State & Zip
Main Contact Name / Main Contact Email
Phone # (plus area code) / ( ) / Fax # (plus area code) / ( )
Section II –Public Agency Representatives/Exhibitor Information
Please list below, name of agency representative/sthat will be at your expo booth. Two representativesare highly recommended with a limit of two representatives per agency. If your agency is combined with another (i.e. City and City School System), the option to share a booth is available. Please contact for details.
Name & Professional Designation(s) / Title / Email Address / Phone #
(plus area code)
1 / ( )
2 / ( )
Expo Booth Signage - Provide Public Agency Name for printing of signage, (name of public agency will be printed exactly as provided):

IMPORTANT EVENT NOTES:Expo booths will be set up for each registered public agency and will be available the morning of the event from 6:00 a.m.-8:45 a.m. Please plan to ARRIVE EARLYthe morning of the event to allow time to set up any agency materials/displays at your booth and to be ready no later than8:45 a.m.The Exhibit Hall will open to Vendors promptly at 9:00 a.m.For public agencies needing overnight lodging, the state lodging rate at the event hotel is offered to event participants at their expense. Please visit VAGP's Event Page for additional details.

Section III - Public Agency Reverse Trade Show Directory Information

Please complete the below information for inclusion in the Reverse Trade Show Directory to be distributed to vendor participants. The Directory should provide vendors with your key agency contact information for future inquiries relating to procurement opportunities, vendor registrations, how to do business with your agency, etc. Additional key staff contact informationis encouraged even if all staff are not able attend the Trade Show. Please submit the below form with your Public Agency Registration Form using the sample format shown below. Please be sure to include area codes for all phone numbers listed. The below template mayalso be used by your agency as a handout the day of the event.

Public Agency Name:
Department: / Department:
Name: / Name:
Title: / Title:
Phone: / Phone:
Email: / Email:
Department: / Department:
Name: / Name:
Title: / Title:
Phone: / Phone:
Email: / Email:
Department: / Department:
Name: / Name:
Title: / Title:
Phone: / Phone:
Email: / Email:
Department: / Department:
Name: / Name:
Title: / Title:
Phone: / Phone:
Email: / Email:

Please provide your agency contact information using the below format.

Public Agency Name: / XYZ Agency
Department: / PURCHASING DEPARTMENT / Department: / PURCHASING DEPARTMENT
Name: / John Doe / Name: / David Smith
Title: / Purchasing Manager / Title: / Contract Officer
Phone: / 123-456-7890 / Phone: / 123-456-7890
Email: / / Email: /
Department: / PURCHASING DEPARTMENT / Department: / PURCHASING DEPARTMENT
Name: / Jane Jones / Name: / Sue Williams
Title: / Contract Administrator / Title: / Vendor Administrator
Phone: / 123-456-7890 / Phone: / 123-456-7890
Email: / / Email: /
Department: / PUBLIC SCHOOL DIVISION / Department: / FACILITIES DEPARTMENT
Name: / Nancy Smith / Name: / Bill Johnson
Title: / Buyer / Title: / Facilities Manager
Phone: / 123-456-7890 / Phone: / 123-456-7890
Email: / / Email: /