Exhibitor Registration

EXHIBITOR REGISTRATION

LLSSA 7th Annual Dealer Conference - Exhibitor Registration
Exhibition will be held on Thursday, June 17th, 2021. Questions and concerns can be directed to Shelley Pettit at (337) 886-7282.
Company Name*
Company Address*
Street Address Address Line 2 City State ZIP Code
Company Phone*
Company Fax
Representative
Information for an individual representing your company.
Representative Name*
Representative Phone*
Representative Cell Phone
Representative Email*
Options
Tables - Early Bird Pricing (if paid prior to May 1st)
Price: $200.00 Quantity:
(If paying on May 1st or later, you must instead use the field below.)
Tables
Price: $225.00 Quantity:
(If paying before May 1st, use the field above to get early bird pricing.)
Morning Break Sponsorship
Price: $100.00 Quantity:
Lunch Table Sponsorship
Price: $100.00 Quantity:
Afternoon Break Sponsorship
Price: $100.00 Quantity:
CEU Class
Price: $150.00 Quantity:
Consent
Consent*
I agree and accept.
By checking this box, you state that you and your company will not hold the LLSSA responsible for any damages or losses that may occur to display and/or material while exhibiting at the annual dealer conference to be held June 17th 2021.