PreReg

Regional Show You Plan to Attend:


HARTFORD SHOW Connecticut Convention Center July 28-30, 2008	GREENVILLE SHOW Carolina First Center August 17-19, 2008	STURBRIDGE SHOW Sturbridge Host Hotel September 8-10, 2008

Store Name
Street Address		Phone
Address (cont.)		ext.
City		FAX
State/Province		Mobile
Zip/Postal Code		E-mail
Country		Web Site

Type of Store:(Hold "Ctrl" key to select more than one)

Main Contact:

Name:

Position:

Responsibilities:

Additional Personnel:

Name:

Position:

Responsibilities:

Name:

Position:

Responsibilities:

Name:

Position:

Responsibilities:

Name:

Position:

Responsibilities:

Name:

Position:

Responsibilities:

Name:

Position:

Responsibilities:

Name:

Position

Responsibilities:

If you have more than eight (8) staff members attending, resubmit form with additional personnel.

After clicking the "Submit" button, the form you have just filled out will be emailed to the EORA office. A "Thank You" page will also appear which reviews the information sent & confirms your information was received.