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Eastern Region Application Form
Deadline: Friday, March 15, 2024
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* Indicates required question
Business Name
*
Your answer
Business Address
*
Your answer
Business Contact Number
*
Your answer
Business E-mail address
*
Your answer
Business Point of Contact (Name & Telephone Number)
*
Your answer
Iota Licensed Vendor Number. (Only a licensed vendor can sell Iota Paraphernalia at the Conference)
*
Your answer
What day will you be arriving?
*
MM
/
DD
/
YYYY
Please check all that apply
*
Non Licensed Vendor with novelty items (Non Greek Items) $ 150.00
Iota Phi Theta® Fraternity, Inc. Financial Member (Licensed Vendor) $ 75.00
Iota Phi Theta® Fraternity, Inc. Financial Member (Non-Licensed Vendor) $ 100.00
Iota National Licensed Vendor $100.00
Additional Tables (specify the number of additional tables needed below) $ 45.00
Required
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