Completion and submittal of this document acknowledges that the participant(s) assumes any risk associated with attendance or participation in the convention and/or events and releases the Nevada Telecommunications Association from any liability due to any injuries and foregoes any claims against said Association for any liability.  See the Convention Page for our Cancellation policy.

Please provide the following CONTACT INFORMATION: 

(Please note:  So we can contact the participant directly should there be changes, it is best to have the main PARTICIPANT's contact information here rather than who actually completes the form.)

Contact Name
Organization
Street address
Address (cont.)
City
State
ZIP/Postal code
Work Phone
FAX
E-mail

NO INVOICE WILL BE SENT TO YOU UNLESS YOU SPECIFICALLY ASK FOR ONE! 

SPONSORSHIP OPPORTUNITIES: Select any of the following options that apply:

(Please note:  Companies sending payment AFTER the deadline must pay the higher registration fee which will be reflected below.) 

REGISTRATION FEES -  TELCO MEMBERS ONLY

Registration fees are waived for Spouse/Partner, retired past presidents and honorary/distinguished members of the NTA.   For guests, please use the drop down menu to select "Guest" next to your name.

Non-Member Telcos are welcome to attend for a registration fee of $500.  Please insert your name below.

REGISTRATION FEES -  ASSOCIATE MEMBERS ONLY

Exhibitors must read and understand the terms and conditions of the hotel.  Registration by each company assumes that the exhibitor has read and understands the terms and conditions.  Click Here  Use your Back Browser to return to this form.

• Each exhibiting company pays for one combined registration fee and exhibit fee.

• Exhibitor fees are limited to one representative and one guest representative per table.  Additional representatives are $50 per person and must be included in your registration fee.  Please list each participant’s name on the registration form (below).

• Associate members wishing to attend the conference but not exhibit pay $250 per person.  See below for non-exhibiting associate members.

• Payment must accompany the application to reserve a display table.

• Paying the additional electrical fees reserves tables near electrical outlets.

• Tables are available on a first-come, first served basis.  The Association reserves the right to assign locations as needed.

• Exhibit space consists of one six-foot draped table and two chairs per exhibit.

• Free-standing partitions provided by the exhibitors are allowed behind the tabletop displays or you may move the table to the back of the area to place tabletop signage.  Please see shipping instructions link.

• Please limit displays to literature and small pieces of equipment.

• A portion of the exhibitor fee will be used to purchase raffle prizes to ensure member companies visit each exhibit.  Specially designed index cards will be issued to each non-exhibiting participant to be initialed by each exhibit.  Only those cards that have been signed off by each exhibitor will be eligible to win prizes. 

• Exhibitors are also welcome to bring their own prizes for additional exposure.

• The Association assumes no responsibility for literature, equipment and/or supplies before, during and after the conference.

Do you need electrical outlet (includes power strip and extension cord)? 

No Yes Electrical outlet fee is $50

Non-Exhibiting Associate Member

SCHOLARSHIP LUNCHEON

Scholarship Luncheon - August 12, 2010, $30 per person. Number of people attending? 

  Paying Registrants 

AWARDS DINNER

Awards Dinner - August 12, 2010, $60 per person. How many attending?

Paying Registrants 

SILENT AUCTION

Do you wish to donate an item? If so, please describe the item for auction or raffle.  If you know the price of the item(s), Please list the value as well.

EVENTS

Virginia City/V&T Railroad Tour/Ponderosa Mine Tour - $50 per person.

Please list each person's name.

Name
Name
Name
Name

Golf Tournament - Genoa Lakes Golf Club $120 per person

Name	Handicap or Average?

Golfer 2

Name	Handicap or average?

Golfer 3

Name	Handicap or average?

Golfer 4

Name	Handicap or average?

Do the players listed above want to play together?

Yes No

Do you want to play with someone else in particular? If so, please type the name below. We will try to accommodate your request.

THANK YOU!  You will receive a confirmation summary that your submittal was sent properly.  NO INVOICE WILL BE SENT TO YOU UNLESS YOU SPECIFICALLY ASK FOR ONE!   Please tally your amounts from your confirmation and submit a check or money order (no credit cards accepted) to:

Nevada Telecommunications Association

P. O. Box 34449

Reno, NV  89533-4449