SENIOR ENRICHMENT DAY
Wednesday, June20, 2018-8:00 A.M.
Exhibitor Registration Form(Please print or type)
Name of Organization: ______
Address of Organization: ______
Phone Number of Organization: ______Email______
Contact Person for Organization: ______
Name of Person(s) who will be working exhibit: ______
______
Does your exhibit require an electrical outlet? Yes______No______
Registration Fee for Exhibiting:
Early Bird Special: Before May 10, 2018 _____ Non-profit Organizations $40.00
Before May 10, 2018_____ For-profit Organizations $70.00
Fee will include ONE lunch: extra people to exhibit will need to pay for luncheon.
Forms postmarked AFTER May 10, 2018, please add $10 to the fee. (Note space is not guaranteed after this date.
Number of those attending lunch (enclose $8.00 fee per add’l person) ______
Names of all those attending luncheon______
Set up for exhibitors will be on the day before the event (June 19, 2018) from 2:00p.m. to 5:00p.m.
Will you be setting up on June 19 from 2p.m. to 5p.m.? Yes____ No_____
One 6’ table and two chairs will be provided. You will need to bring your own skirting/linens if desired.
Please Note: Only one agency per form. Conference day registrations are strongly discouraged and may not be accommodated. Your canceled check is your receipt.Confirmations will not be mailed. If you provide a legible email address, your registration will be confirmed via email. There will be no refunds.
Questions? Please callLarisa Draves, Draves & Associates at 231-823-0015 or
Make checks payable to: “Senior Enrichment Day”
Mail to: Larisa Draves, Exhibit Manager
Draves & Associates
21486 Eight Mile Road
Stanwood, MI 49346
(NOTE: DO NOT SEND CHECKS TO MECOSTA CO COMMISSION ON AGING. Send to address above) (over for page 2 of the form)
Optional: Do you want to conduct a drawing for a giveaway at your table? All prize winners will be announced at the luncheon.
Please list item and brief description below:
Do you need any other special accommodations for the day? (Please list below.)
Thank you for your help in making
Senior Enrichment Day 2018
a special day for many seniors and their guests!