JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration Form
CIL-Con
September 9-10,2022
Cross County Mall, 700 Broadway Ave. E, Mattoon IL 61938
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Business Name:
*
Your answer
Contact Name:
*
Your answer
Contact Phone:
*
Your answer
Contact Address:
*
Your answer
Email:
*
Your answer
Website:
Your answer
Type of Product or Services:
Your answer
Would you like to be considered for a speaker/presentation spot during the event?
Yes**
No
Maybe
Clear selection
Topic:** (if Yes above) otherwise leave blank.
Your answer
AV Needs:** (if Yes above) otherwise leave blank.
Your answer
Vendor Booths (approx. 10x10)
Include 1 Table and 2 chairs for $100 Add'l Tables Available for $10 (up to 2). You may purchase 2 booths for a 20x20 area. If you are in need of 3 booths or more please contact Becky at
Zitaheals@gmail.com
for pricing.
# of Booths Requested:
Your answer
All booths include electricity. Please bring an extension cord & table cover. Booth area is approximately 10x10. You may bring additional tables for free.
Any questions or concerns contact
zitaheals@gmail.com
Booth Rental Fee + Add'l Table Fee = Total Due: (Calculate total and state when and how payment will be made if you want a PayPal Invoice email
zitaheals@gmail.com
)
Your answer
Payment Information
Payment can be sent via Pay Pal to: Paypal.me/cilcon or you can request a Pay Pal Invoice be sent to you by emailing
zitaheals@gmail.com
Via Mail:
CIL-Con * Po Box 306 * Mattoon IL 61938
Checks can be made payable to CIL-Con
Refund Policy
Refunds requested prior to May 1, 2022 will receive a full refund. From May 1-July 31st a $30 cancellation fee will be charged. NO REFUNDS after August 1, 2022.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms