Exhibitor Registration for the
8th Annual Northeast Safe Patient Handling Conference.

Date: Friday, October 6, 2017
Location: Grappone Conference Center, Concord, NH

This is the form for paying online with a credit card.
If you would like to pay with a check, please use our Information Packet.


Fields with an asterisk are required.
Company*
Contact Name*
Email*
Phone*

Sponsorship Level* — see our exhibitor information packet for details


Booth Staff - please list the names of all booth staff exactly as you want them to appear on the name tag.
Name 1 included    
Name 2 included    
 
Additional booth staff - $50 each. Additional Cost  
Name 3    
Name 4    
Name 5    
Order Total
Comments or Questions:

Enter your payment details
First Name*:
Last Name*:
Address*:
City*:
State*:
Zip*:
Phone :
Card Number*: Expiration (MM/YY)*: Security CVV*: