(Please Print-Copy and paste into a word document then send to address below.)

CDID Vendor Registration for 2013 Symposium

Company Contact Information:   
Company Name:  
Primary Contact:  
Phone:  
Email  

Table Rental Fees: 
                                                                                   Fee     Quantity     Total
Prior to Jan 30th                                                       $800    
After Jan 30th                                                           $1000    
Table Dressing and Electricity                                   $175    
Salesperson Friday & Saturday Lunch                      $60     
  
Total      

           
Type of Remittance Check Here Credit card Number and Exp. Date
Credit Card (visa or master only)    

Check    

Please print the names of attending salespeople: 

CDID- 3713 Calumet Avenue, Manitowoc, WI 54220 or

email to lorettabrandl@yahoo.com or

fax to (920) 682-6983

Any question please contact Loretta Brandl (920) 860-5432