Exhibitor and Sponsor Registration

Registration Type
Exhibit Table for SDPhA Associate Members - $600
Exhibit Table for Non-SDPhA Associate Member - $750
Convention Sponsorship -
Do you need electricity? (Additional Charge May Apply)
Yes No
Company / Contact Information
Name:
Company:
Address
Zip
City
State
Phone
Fax
Email
Attendee's Information
Name:
Company:
Address
Zip
City
State
Phone
Fax
Email

Second Attendee's Information
Name:
Company:
Address
Zip
City
State
Phone
Fax
Email
Jacks Football Tickets
($20 per ticket)
Payment Information
Billing First Name
Billing Last Name
Billing Address
Billing Zip
Billing City
Billing State
Amount to Charge:
Card Type
Credit Card #
CVV # What is my CVV code? Expiration Date

I Agree to Pay the amount and by the method selected above.

Exhibitor Only