VENDOR REGISTRATION FORM

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The hotel registration deadline is August 23, 2022.

Conference Dates: September 14-16, 2022
Location: MSU Riley Center & Threefoot Hotel ~ Meridian, MS
Venue Address: 601 22nd Avenue, Meridian, MS 39301

For Questions: contact Chelsey Gilliam at (662) 915-5951or by email: chelsey@olemiss.edu
Or, Ramey Smith at (662) 915-7857 or by email:rameys@olemiss.edu

Email *

First Name *

Last Name *

Business Name *

Cell Phone Number *

Please use the following format when inputting your phone number; ###-###-####

Please list names of all employee attending this conference. *

Vendor/Exhibitor Registration Fee is $150.

We will pay at conference.

We will be sending a check prior to the conference to MJC, P.O. Box 1848, University, MS, 38677.

I am a state agency and request a waiver.

Hotel Accommodations *

Yes, I will make my reservation @ The Threefoot Hotel.

Yes, I will be making alternative reservations.

No, I will be commuting

Masking and Social Distancing *

I acknowledge that MJC will be observing the Supreme Court's Emergency Administrative Orders related to masks and social distancing for all conferences.

Required

MJC Reimbursement Policy *

By checking the box, I acknowledge that MJC requires 80% attendance to be eligible for reimbursement.

Required

A copy of your responses will be emailed to the address you provided.

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