Exhibitor Application 2010

EXHIBITION SPACE REGISTRATION FORM The 20th Annual International Conference on Soils, Sediments, Water, and Energy, March15-18, 2010 Mission Valley Marriott, San Diego, CA

ON-LINE REGISTRATION IS AVAILABLE AT www.aehsfoundation.org 1. PLEASE PRINT OR TYPE THE FOLLOWING INFORMATION, AS YOU WOULD LIKE IT TO APPEAR ON CONFERENCE LITERATURE AND BOOTH SIGNAGE: Company Name (exactly how it is to appear on booth signage)____________________________________________________ Address _______________________________________________________________________________________________ City_____________________________________________________ State _________________ Zip_____________________ Contact Person____________________________________________________ Title__________________________________ Telephone ________________________________________________ Fax__________________________________________ Contact Email ________________________________________________URL_______________________________________ 2. PLEASE PROVIDE A COMPANY DESCRIPTION. THIS INFORMATION WILL BE PRINTED IN THE EXHIBITOR DIRECTORY (may send by email (preferred): [email protected])

3. FEES: _______ 8’ X 10’ or 6’ X 10’Booth space @ $1295.00 (as selected – layout will be emailed to you) _______ Supporter* Booth space @ $695.00 _______ Sponsor* Booth space @ No Charge _______ Special Session Sponsor* Booth space @ No Charge *If your company is interested in becoming a Supporter, Sponsor, or Special Session Sponsor of the West Coast Conference, please contact Brenna Lockwood at 413-549-5170, [email protected] or visit our website, www.aehsfoundation.org 4. PLEASE LIST NAME AND AFFILIATION OF PERSONS ATTENDING AS BOOTH STAFF (up to 4): ___________________________________________

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5. LUNCH OPTION: LUNCHES ARE NOT INCLUDED WITH THE BOOTH PACKAGE AND MUST BE PURCHASED SEPARATELY. LUNCHEONS ARE $32.25 PER PERSON AND MAY BE PURCHASED ON SITE AT THE CONFERENCE.

6. PAYMENT INFORMATION (check or credit card accepted) Payment by check (checks payable to AEHS Foundation) FIN # 262624347 Visa Card Number

MasterCard

American Express

Discover Expiration Date

Cardholder Name_________________________________________________________Date________________________________ FAX OR MAIL FORM TO: AEHS Foundation, Brenna Lockwood, 150 Fearing Street, Suite 21, Amherst, MA 01002  Telephone: (413) 549-5170  Fax: (413) 549-0579 CANCELLATION POLICY: Cancellations received in writing on or before January 31st will receive a full refund minus $100 processing fee. Refunds will not be issued for booth spaces cancelled after January 31st.