Vendor Registration Information

Vendor Registration Information

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Vendor support is essential to the success of the meeting and vendor supported speakers are encouraged. A copy of the program identifying the program sponsor, the program chairpersons, moderators and faculty will be available for next years meeting. An update will included the agenda with presenters and their topics. Please note that the vendor registration fee of $750.00 can be paid on-line next year. PayPal will only provide us the name on the credit card. Name tags must be worn to gain access to the meeting. In order to provide you with a name tag please provide us with your company name and all company representatives and or speakers. If not using PayPal to register you can highlight and print form below for mailing or download registration form and e-mail to the Missouri Perfusion Society Treasurer, Kellie Merrigan, 15406 Ironhorse Circle, Leawood, KS 66224 The Missouri Perfusion Society is a non-profit organization. Tax ID and related information is available upon request. Refunds will not be available once a guarantee of attendance has been given to the host site. Kellie Merrigan, kamerrigan@cmh.edu On Line
THE MISSOURI PERFUSION SOCIETY 18th ANNUAL SCIENTIFIC MEETING JUNE 7^th & 8^th, 2013 VENDOR REGISTRATION Vendor: _________________________________________ Contact Person: _________________________________________ Telephone Number: _________________________________________ E-mail address: _________________________________________ Names of those attending: ___________________________________ (3 maximum) ___________________________________ ___________________________________ Please help us plan for food and beverage service. Indicate the number of persons attending the following: Friday lunch_____ Friday reception: _____ Saturday breakfast: _____ Saturday lunch: _____ Please make your check for $750.00 payable to The Missouri Perfusion Society Mail your check and this form to: Kellie Merrigan, Treasurer 15406 Ironhorse Circle Leawood, KS 66224