State Speech Exhibit Application

"*" indicates required fields

Organization*

Organization/Product*

Description of organization or product; limit 50 words.

Website

Booth

Booth Fee

Price:

Electricity Needed?*

You are responsible for supplying extension cords and power strips.

Yes

Special Requests

Any additional notes about your table reservation.

Merchandise/Swag

Please list any items you plan to sell or give away during exhibiting. Exhibitors may not sell T-shirts, hoodies, or drawstring backpacks.

Exhibit Staff

Contact 1 Name*

First Last

Contact 1 Email*

Contact 1 Cell*

Contact 2 Name

First Last

Contact 2 Email

Contact 2 Cell

Additional Contacts

Please enter names of additional staff; if you do not yet know who they are, just type numbers (1, 2, 3, 4, 5, etc.)

First Name

Last Name

Payment

Invoice Number

Subtotal

$0.00

Payment Type*

If payment by check, it must be received before you exhibit.

Credit Card

Check by Mail

Check at Festival

Purchase Order

Discount Code

If you have been given a discount code by the State Office, please enter it here.

Purchase Order Number*

Credit Card Processing Fee

Price: $0.00

Total

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Date Paid

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ChkNo

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Order Notes

After clicking the submit button, the next screen that loads will collect your payment information; you must complete the next screen for the credit card payment to go through.

Phone

This field is for validation purposes and should be left unchanged.