Exhibit Space Application

Arizona-Sonora SMTA Expo & Tech Forum

Fiesta Resort Conference Center, Tempe, AZ

Wednesday, December 7, 2011

Exhibit space at the Arizona-Sonora SMTA Expo & Tech Forum entitles you to:

● Draped table ● Two chairs ● Electricity ● Attendee list ● Directory listing ● Company sign ● Lunch ● Free Wi-Fi

* SMTA Corporate Members receive reduced prices!

PAYMENT INFORMATION:

SMTA Corporate Members / Non-Corporate Members / Quantity
Tabletop Exhibit Space / $450 / $525
Will you require 110V Electricity? / Yes / No

q  I have enclosed a check made payable to the SMTA for the amount indicated above.

q  I have paid by credit/debit card online.

To pay by credit/debit card, please register online at http://www.smta.org/chapters/chapters_detail.cfm?chapter_id=9

MARKETING OPPORTUNITIES:

Please contact me for: □ Show Directory Advertisement ($125-200) □ Gold/Silver/Copper Sponsorships

SHOW INFORMATION:

Information provided below will be used for the Show Directory; please provide information exactly how you would like it printed.

If pre-show information should be sent elsewhere, please provide an alternate shipping address below.

Company Name

Address City State Zip

Phone Fax E-mail URL

Show Contact (Please Print) Title Date

SHIPPING ADDRESS FOR PRE-SHOW INFORMATION (if different than above):

Name/Company

Address City State Zip

Phone Fax E-mail

TABLE PERSONNEL: 1. 2.

Please print badges for:

3. 4.

5. 6.

PRODUCT/SERVICE DESCRIPTION:

Please provide a 100 word or less product/service description to be used in the Show Directory. Each exhibitor is allotted a quarter page in the Show Directory for their Contact Info and Product/Service Description. *Please note: this information can be included on a separate sheet or e-mailed to .

Please return completed application form to: Ron Molnar, AZ TECH DIRECT, 13801 S. 32nd Place, Phoenix, AZ 85044

Tel (480) 215-2654 Fax (480) 496-9451 Email:

Cancellation Policy: All exhibit space fees are non-refundable