2022 EXHIBITOR REGISTRATION FORM

Annual South Central Joint Mine Health & Safety Conference
The Hilton Anatole~ Dallas, Texas
April 18 – 21, 2022

NOTE: Each TABLE TOP booth includes one draped table (optional undraped), one chair, all draping will be black. IF YOU PREFER A DIFFERENT ARRANGEMENT please specify below; we will notify you if there is an additional charge to accommodate your special needs:
Company Name:*
Company Mailing Address*
Street Address Address Line 2 City State ZIP Code
Primary Person (Point of Contact):*
First Last
Email*
Phone*
Description of Company*
Please provide a brief description of services and / or products the company offers as soon as possible to post to our “2024 LIST OF EXHIBITORS”. This includes website, mailing address you wish to have listed, Phone number, email address, etc
FEES:
Booths : $895 /each Quantity*
Basic Fee includes One Participant Registration per booth includes all meals & refreshments served by the Conference, including attending any sessions or workshops. DISCLAIMER: By Registering for the conference, you understand photographs will be taken and used on our website. All Company and personal information will be protection. WE DO NOT SHARE ANY LIST OF PARTICIPANTS. Thank you for your support!!
Price: $895.00
Requested Booth Numbers*

Please list the booth or booth numbers requested
Additional Participant: $375 each Quantity
Includes all meals & refreshments served by the Conference, including attending and any sessions or workshops. DISCLAIMER: By Registering for the conference, you understand photographs will be taken and used on our website. All Company and personal information will be protection. WE DO NOT SHARE ANY LIST OF PARTICIPANTS. Thank you for your support!!
Price: $375.00
There are 20 table top booths available first come first served. All booths are priced at $895.00 Please Use online form for booth fees, Extra exhibitor services are separate.

Booths must be PAID IN FULL to be added to our website Exhibitor Hall Diagram
By registering for the conference, you understand photographs will be taken and used on our website.
REQUIRED FOR NAME BADGES:
Name & Title of each Attendee
Card Billing Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Total Due
$0.00
Credit Card
Card Details
Cardholder Name
Name
This field is for validation purposes and should be left unchanged.

2022 EXHIBITOR REGISTRATION FORM

FEES:

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