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Displayer Registration Form
Thank you for your interest in becoming a displayer for Sciematics 2020, please use the following form to register.
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* Indicates required question
Company/Organization Name:
Your answer
Company website address (for publication in the program):
Your answer
Contact Individual Name:
Your answer
Mailing Address:
Your answer
City/Town
Your answer
Province
Your answer
Postal Code
Your answer
Phone Number
Your answer
Email Address:
Your answer
The receipt should be made out to:
Option 1
Clear selection
Number of tables requested: (@ $250 (1st table) + $125 for each additional table (50% off for non-profit organizations))
Your answer
Number of Lunch tickets: (One free ticket per table purchased; each ticket thereafter is $15)
Your answer
Do you require electricity? (there is a limited number of outlets available)
Yes
No
Clear selection
We are a Not-for-Profit Organization:
Yes
No
Clear selection
Total amount of cheque enclosed:
Your answer
I/we would be interested in doing a workshop as well.
*
Yes
No
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