SEDA 2016 Annual Symposium Exhibitor/Sponsor Registration – Bonita Springs, FL Hyatt Regency Coconut PointBonita Springs, FLJune 5-8, 2016 RegistrantSalutation*Mr.Mrs.Ms.Dr.First Name*Last Name*Company*Job Title*Address*City*State*Zip/Postal Code*Country*Telephone*CellFaxEmail* Email Notifications*Yes, I authorize receiving publication email notificationsNo, I would not like to receive publication email notifications (opt-out)Authorization for receiving publication email notification from SEDA. (applies to all email addresses on this form)Website Special Needs Food Allergies (describe in comments) Gluten Free Meals Halal Meals Vegan Meals Vegetarian Meals Wheelchair Access Other (describe in Comments) Member SEDA AMTA (check all that apply) Sponsor OpportunitiesAll sponsorships are recorded based upon receipt of registration and full payment. Sponsorship is available to SEDA Members in good standing.Sponsors will receive: -Platinum Level: Includes 1 Exhibitor Package or 2 Full Registrations, Sign Recognition at Meeting Room Entrance, Sign Recognition at Welcome Dinner Reception & Recognition at 5 Session Starts -Gold Level: Includes 1 Exhibitor Package or 2 Full Regisrations, Recognition at 5 Breaks & 2 Meals -Silver Level: Includes 1 Exhibitor Package or 2 Full Registrations & Recognition at 2 MealsAll Sponsors will Receive: -List of attendees sent via e-mail two weeks prior to Symposium -Acknowledgement in the attendee materials - 100 word company description (please e-mail to: registration@southeastdesalting.com) -Recognition during the programEvent Sponsor*Platinum Sponsor, $1,500Gold Sponsor, $1,250Silver Sponsor, $1,000No SponsorshipSponsorship are available to members in good standing.Sponsorship Package: Your Choice*Exhibit PackageIncludes 1 Full Attendee with Exhibit Space2 Full AttendeesIncludes 1 Additional Full Attendee RegistrationExhibit Space*Table-Top ExhibitTrailer Space Exhibit (Trailer length must be 24' or less)Included in the sponsorship package.Symposium Attendee?*Yes, Same as aboveNo, Different from aboveExhibit OpportunitiesAll Exhibitors must have company membership (not individual membership with SEDA).All Exhibit Spaces will be Selected on a First Come/First Served Basis at the Time of Registration and Payment in Full.All Exhibitors will Receive: -One full attendee registration to the Symposium-List of attendees sent via e-mail two weeks prior to Symposium -Acknowledgement in the attendee materials - 100 word company description (please e-mail to: registration@southeastdesalting.com) -Sign recognition during the programExhibit Space*Table-Top Exhibit, $75010% Deposit Table-Top Exhibit, $75Trailer Space Exhibit (limit 3), $75010% Deposit Trailer Space Exhibit, $75No ExhibitAllocated on a first come/first serve basis upon receipt of 10% deposit and registration form; full payment must be made by March 31, 2016 or deposit and booth space will be forfeited.Symposium Attendee?*Yes, Same as aboveNo, Different from above Included Registrant 1Attendee different from above.Salutation - Included Registrant 1*Mr.Mrs.Ms.Dr.First Name - Included Registrant 1*Last Name - Included Registrant 1*Company - Included Registrant 1*Job Title - Included Registrant 1*Address - Included Registrant 1*City - Included Registrant 1*State - Included Registrant 1*Zip/Postal Code - Included Registrant 1*Country - Included Registrant 1*Telephone - Included Registrant 1*Cell - Included Registrant 1Email - Included Registrant 1* Included Registrant 2Salutation - Included Registrant 2*Mr.Mrs.Ms.Dr.First Name - Included Registrant 2*Last Name - Included Registrant 2*Company - Included Registrant 2*Job Title - Included Registrant 2*Address - Included Registrant 2*City - Included Registrant 2*State - Included Registrant 2*Zip/Postal Code - Included Registrant 2*Country - Included Registrant 2*Telephone - Included Registrant 2*Cell - Included Registrant 2Email - Included Registrant 2* Exhibit SpacePlease select your choices for the exhibit space.Full payment must be made by March 31, 2016 or deposit and booth space will be forfeited.Click image to view layout 3 trailer spaces available. Location to be determined. Exhibit Space Number: First Choice*1 - N/A Sold2 - N/A Sold3 - N/A Sold45 - N/A Sold67 - N/A Sold8 - N/A Sold910 - N/A Sold11 - N/A Sold12 - N/A Sold1314 - N/A Sold15 - N/A Sold1617 - N/A Sold18 - N/A Sold19 - N/A Sold20 - N/A Sold21222324 - N/A Sold25 - N/A Sold26 - N/A Sold27 - N/A Sold282930 - N/A Sold Exhibit Space Number: Second Choice*1 - N/A Sold2 - N/A Sold3 - N/A Sold45 - N/A Sold67 - N/A Sold8 - N/A Sold910 - N/A Sold11 - N/A Sold12 - N/A Sold1314 - N/A Sold15 - N/A Sold1617 - N/A Sold18 - N/A Sold19 - N/A Sold20 - N/A Sold21222324 - N/A Sold25 - N/A Sold26 - N/A Sold27 - N/A Sold282930 - N/A Sold Exhibit Space Number: Thrid Choice*1 - N/A Sold2 - N/A Sold3 - N/A Sold45 - N/A Sold67 - N/A Sold8 - N/A Sold910 - N/A Sold11 - N/A Sold12 - N/A Sold1314 - N/A Sold15 - N/A Sold1617 - N/A Sold18 - N/A Sold19 - N/A Sold20 - N/A Sold21222324 - N/A Sold25 - N/A Sold26 - N/A Sold27 - N/A Sold282930 - N/A Sold Exhibit Space Number: Fourth Choice*1 - N/A Sold2 - N/A Sold3 - N/A Sold45 - N/A Sold67 - N/A Sold8 - N/A Sold910 - N/A Sold11 - N/A Sold12 - N/A Sold1314 - N/A Sold15 - N/A Sold1617 - N/A Sold18 - N/A Sold19 - N/A Sold20 - N/A Sold21222324 - N/A Sold25 - N/A Sold26 - N/A Sold27 - N/A Sold282930 - N/A Sold Total Registration FeeTotal $0.00 Payment InformationPayment Method*Credit Card - Online PaymenteCheck - Online PaymentCheckInvoice CommentsIf you would like a copy of the invoice/receipt sent to another*Yes, send copy of invoice/receipt to:No, don't need a copy sentIf yes, you would like a copy of the invoice/receipt sent to another other than the attendee please enter information below.Name* First Last Email Address* Comments or Instructions Written cancellation requests received by the Southeast Desalting Association (SEDA) at least 5 days before a scheduled event will receive a refund, less a $50 administrative processing fee. Full payment is required if the request is received less than 5 days of the scheduled event and no refund will be available. A credit may be issued less a $25 recordkeeping fee towards a future event provided that it is redeemed within 12 months of the credited scheduled event. The credit will be forfeited if not used within the 12 months timeframe. A substitution of the registrant may be made any time without cost up to the date of the event. The requested amount of a refund or credit must exceed their respective administrative processing fees as described above in order to be considered. SEDA reserves the right to make changes to the scheduled event including but not limited to changing the event location, scheduled date(s), program and speakers, or to cancel the event in its entirety when conditions beyond its control prevail. If the event is cancelled, SEDA’s liability is limited to providing a full refund of the fees paid toward the scheduled event. 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