Learning Disabilities Association of Missouri
40th Annual Conference
October 3 & 4, 2008
 Tan-Tar-a Hotel & Resort
Osage Beach, MO

Exhibitor Application and Contract

Organization/Company Name_______________________________________________________

Address ________________________________________________________________________

City, State, Zip __________________________________________________________________

Contact Person __________________________________________________________________

Phone Number (______) _______ - ____________ Fax (_______) _______ - ________________

E-Mail Address _________________________________________________________________

Name (s) and Title (s) of Company Representative (s) attending (Please type or print)

1.______________________________________________________________________________

2. ______________________________________________________________________________

Booth Rental  
$160 if prior to May 31, 2008                                 
$180 if submitted after May 31, 2008

 $ ______________
Additional Charges $ ______________
  • Electrical Hook-up $15.00
$ ______________
  • Additional Table (s) $45.00 each
$ ______________
  • Additional Chair (s) $5.00 each
$ ______________
  • Friday Awards Luncheon $20.00 each
$ ______________
Total $ ______________

No assignments for booth space will be made without full payment.
Deadline is August 31, 2008. Full payment is due on that date.

Authorized Signature __________________________________ Date ________________________