4th Annual Whole Child Summit Exhibit Request Form

Exhibitor Information

January 17-18, 2019 - Sheraton Portland Airport Hotel

Please complete the following form to reserve your space to exhibit at the 4th Annual Oregon Whole Child Summit. You will be contacted shortly after submitting to confirm your spot as an exhibitor.

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* 1. Name of your organization

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* 2. Brief description of your organization

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* 3. Contact Information:

Name:

Company:

Address:

City/Town:

State:

ZIP:

Email Address:

Phone Number:

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* 4. Representative at the conference (up to two):

Rep 1 Name:

Rep 1 Email:

Rep 1 Cell:

Rep 2 Name:

Rep 2 Email:

Rep 2 Cell:

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* 5. How many booths are you requesting?

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* 6. My booth requires:

Electricty

Internet

Neither

Other (please specify):

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* 7. Would you like to receive information on additional sponsorship opportunities?

Yes! Please send me the sponsorship packet.

Not at this time, thank you!

I would like to hear about future exhibit opportunities with COSA!

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* 8. Please submit your logo for promotional purposes

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.

Choose File

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* 9. Please include your organization's website

The $500 includes skirted 8' table. Also included will be continental breakfast and lunch.

Upon completing this form, an invoice will be processed and mailed to the address you provided above. You will receive an initial confirmation email with set up/tear down times, as well as additional information regarding logistics. A final confirmation with a pre-conference attendee list will be sent prior to the conference. If you have any questions, please contact Meghan Cusick Olson at meghan@cosa.k12.or.us