Exhibitor Registration Form Thank you for choosing to exhibit with C&H Educational Systems. Please complete this vendor application form and email it to firstname.lastname@example.org. YOUR NAME(Required) First MEETING REPRESENTATIVE NAME First COMPANY NAME Email PhoneAddress Street Address City State / Province / Region ZIP / Postal Code INDICATE WHICH MEETING YOU ARE REGISTERING FOR• French Quarter Festival Anesthesia Update (October 1-3, 2021) Registration Deadline: September 1 • Wine Country Anesthesia Update (January 10-13, 2022) Registration Deadline: December 10 Upon receipt of this form, an invoice for your $700 3-Day Registration Fee will be emailed to you and is payable via credit card or check. Fee includes: • One 6ft. skirted table and one chair (additional vendor badges available at $50/each). • Access to all meeting refreshments including buffet breakfastRegistration Fee (French Quarter Festival Anesthesia)(Required) Day 1 - $400 Day 2 - $400 3-Day Full Registration - $700 Registration Fee (Wine Country Anesthesia)(Required) Day 1 - $400 Day 2 - $400 3-Day Full Registration - $700 Registration FeeTotal Payment InformationChoose Your Payment Method(Required) Debit / Credit Card Mail My Payment Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Credit CardPlease check if you have activated a Stripe feed for your form.