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(337) 886-7282
llssa@llssa.org
About
News
Code of Ethics
History
Board of Directors
Scholarships
Licensing
Membership
Application
Benefits
Events
Convention
Dealer Conference
All Events
Education
Contact
Store
About
News
Code of Ethics
History
Board of Directors
Scholarships
Licensing
Membership
Application
Benefits
Events
Convention
Dealer Conference
All Events
Education
Contact
Store
(337) 886-7282
llssa@llssa.org
EXHIBITOR REGISTRATION
Dealer Conference 2021 Registration - Exhibitor
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
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
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.