WVRA 2006 Annual Conference

WVRA 2011 Annual Conference Exhibit Registration Form November 17-18, 2011 The Greenbrier, 300 W. Main Street White Sulphur Springs, WV

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WVRA Tax Exempt # 556028358 ______

Company Name and Address: ______

Representative’s Name/ Address ______

Phone______Fax ______E-Mail ______

Number of tables at $250.00 per table ______Amount enclosed: $______Electricity: Yes ______No______

Phone/Internet: Arranged through The Greenbrier Sales Office by the vendor. Special Needs: ______

Door Prizes: Yes______No ______

Names for nametags: ______

Please Note: To guarantee exhibiting space, all fees must be paid to the West Virginia Reading Association on or before October 30, 2011. Exhibiting space will not be guaranteed until table fees are paid in full.

Return this form and check made payable to: WRVA to:

Frances Horton FAX: 304-736-3297 6019 Pullen Ct. E-mail: [email protected] Barboursville, WV 25504 Phone: 304-736-5839

Table fee: $250.00 per table for Thursday and Friday.