Operator Expo Registration Form for Exhibitors
Date

Membership:

Registration Fee:

$

Any Additional Registrants:

$
Registrant #1: T-Shirt:
Registrant #2: Free T-Shirt:
Registrant #3: $ T-Shirt:
Registrant #4: $ T-Shirt:
Registrant #5: $ T-Shirt:
Registrant #6: $ T-Shirt:
Registrant #7: $ T-Shirt:
Registrant #8: $ T-Shirt:
Company:
Address:
City:
State:      Zip Code: 
Telephone:  xxx-xxx-xxxx
Fax:  xxx-xxx-xxxx
E-mail:
Product/Service You Will Demo:
Special Requests:

The Necessities (Indicate by checking all that apply)

Unless you mark this section, you are not guaranteed any of the listed options.
Electricity (bring your cords) Water (bring your hoses)
Outdoor area for large equipment Approximately what size equipment area will be needed?
Additional Tables:  $10 each (One table included with each booth)

Exhibitors must download and sign liability form and return by fax to (615) 898-8283

Sponsorship(Indicate by checking all that apply)
I will contribute door prizes I will hold a contest in my area
I will provide refreshments in my area I will help sponsor breakfast and lunch ($100)
I would like to help sponsor the TAUD Expo T-shirt ($150) Name for shirt

Grand Total  $
Pay by Credit Card
Pay Later		 Credit Cards

Credit Card Information

First Name As it appears on card
Last Name As it appears on card
Billing Address
Billing City
Billing State
Billing Zip Code
Card Type
Card Number Enter number without spaces
Expiration Date mm/yy
Amount of Payment $
Do you want a receipt? Yes  No
E-mail Address