Space Coast HR Conference

First Name:

Last Name:

E-Mail:

Phone

Street

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Name, as desired for badge

Attendee Title

Company Name

Meal Selection
Champagne Chicken
Salmon with Dill Sauce
Vegetarian/Pasta Plate

Will a second person be attending with you?
Yes
No

Name as desired for 2nd badge

Meal selection for 2nd person
Champagne Chicken
Salmon with Dill Sauce
Vegetarian/Pasta Plate

Do you need electricity on the day of the event?
Yes
No

If you plan to use a display, will it be:
Set up on the floor
Set up on the table that we provide

How tall is your display?

Do you prefer to have an exhibit table inside or outside our Speaker Presentation Room?
Inside
Outside

Please read our Cancellation & No Show Policy below.
Yes (I have read & accept this policy)
No (I have read & do not accept this policy)

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