Northwest Wisconsin Lakes Conference
Registration deadline June 7, 2017
Business Name
Business address
City / State / Zip / Phone
E-mail / Web
Representatives:
Conference registration for each representative costs $45.00\ person, which includes admission, refreshments, lunch and conference materials. Students may attend free of charge, their names and school affiliation is required. List name(s) of all the representative(s) attending as it should appear on a name tag.
Exhibit table fee
First table $100.00 X __1__; each additional tables $15.00 X # tables ð
(each Includes one 8 x 3 ft. table, table cloth, and a chair)
Do you need a power outlet? Yes No / $
Conference registration(s) ………………………………..……….. $45.00 x # attending ð / $
Total Exhibit and Conference ð
* Registration must be received by June 7, 2017 / $
Payment method
Charge my (circle one): Visa, MC, Discover / Check enclosed (payable to Northland College)
Credit Card # / Security code / Exp. Date /
Print name on card / Signature
Mail registration form and payment to:
NWLC Registration · Sigurd Olson Environmental Institute · 1411 Ellis Ave · Ashland, WI 54806