Pennsylvania Recreation and Park Society, Inc

Pennsylvania Recreation and Park Society, Inc. 6th Annual Greenways and Trails Summit Educational Display CONTRACT

Please complete the appropriate sections and return this contract with your deposit. Please print clearly or type and keep a copy for your records.

GENERAL INFORMATION:

Company: ______

Address: ______

City: ______State: ______Zip: ______

Phone: (_____) ______Fax:______

Website: ______Email:______

We wish to reserve______(indicate quantity) educational display(s) at the 2011 PRPS Greenways and Trails Summit to be held at the Yorktowne Hotel, York, PA from September 11-13, 2011. We understand that there is no fee for this display space. If we require electric it is $20 to cover the expense. We agree to comply with the rules, regulations, and provisions established by the Pennsylvania Recreation and Park Society.

Authorizing Signature: ______Title:______Date:______

Type of Exhibit Space: Table Top (6’ Draped Table):______Space for Stand-Alone:______

PRODUCTS/SERVICES: (For listing in Program Guide; 40 words or less; please print or type; attach additional sheet if necessary)

______

DISPLAY REPRESENTATIVES:

Name: ______

Title: ______

1 Name: ______

Title: ______

*ADDITIONAL INFORMATION ON REVERSE SIDE

2 ADDITIONAL ITEMS: PAYMENT INFORMATION:

 Sponsorship  Display Space No Charge We are interested in the possibility of  Electric @ $20 $ ______sponsoring at the 5th Annual Trail Summit. Please contact us: PRPS SUPPORTING MEMBERSHIP  Renewal @ $190 $ ______Contact Person:  New Member @ $150 $ ______ Building Fund Contribution $ ______(Tax-deductible) Phone: (_____) ______TOTAL DUE $ ______ Accessibility Accommodations AMOUNT ENCLOSED $ ______Please check here if any of the company representatives require special accessibility or accommodations at this function. Attach specifications. METHOD OF PAYMENT

 IMPORTANT INFORMATION FOR CHECK ENCLOSED CHECK #:______EDUCATIONAL DISPLAYS Make check payable and mail with contract to: PRPS 1. Although the space is complimentary, should 2131 Sandy Drive you desire to attend educational sessions or State College, PA 16803 events, you must register as a summit attendee.  BILL CREDIT CARD: ____Visa ____MC ____AmEx ____Discover 2. Electric is available from the convention center. If you need electric please check here Card #______Exp.______and we will set it up for you. There is a $20 charge for electric. 3-digit number on back of card: ______(V, MC, DCVR) 3. Please fill out this form and mail or fax to 4-digit number on back of card: ______PRPS no later than August 12, 2011 (See below (Amex) and right for contact address and fax number). Signature______4. If you have any questions, please contact Emily Gates by phone (814) 234-4272, fax (814) 234-5276, or email [email protected]. FOR PRPS OFFICE USE Thank you! Date Received: ______

Entered in Database: ______3

Amount Paid