ACTE

515 King Street,
Ste. 330
Alexandria, VA 22314
USA

Tel:1-703-683-5322
Fax:1-703-683-2720

E-mail: [email protected]

 

Conference Registration Form for
ACTE XII Technology Experience

Technology Vendors: You must complete both the Vendor Registration and the Conference Registration to avoid processing delays.
Vendor Representatives: Each vendor is allowed a maximum of two people per kiosk included in the Vendor Registration of $5,000 (USD)
Vendor Representative Registration Information (1)

Prefix

Mr. Mrs. Ms.

Last Name

First Name

Middle Initial
Badge Full Name
Company
Title

Address

Address*

City

State/Province

Zip/Postal Code

Country

Telephone

Facsimile*

E-Mail

 
Vendor Representative Registration Information (2) OPTIONAL

Prefix*

Mr. Mrs. Ms.

Last Name*

First Name*

Middle Initial*
Badge Full Name*
Company*
Title*

Address*

Address*

City*

State/Province*

Zip/Postal Code*

Country*

Telephone*

Facsimile*

E-Mail*

   

Registration Fees
Individual Registration Fees are quoted in US dollars.

**Technology Experience vendors may participate in all official social events, meal functions, keynote presentations and general sessioins.