Exhibitor Registration Form
Death & Dying Expo - Civic Hall -Mullumbimby Saturday 28th June 2025
Exhibitor & Speaker application (fill out all drop down arrow sections)
Applicant Name
*
First Name
Last Name
Position
Ex: owner / representative / celebrant / director
Business Name/ Organisation
*
Service / sector
*
Please Select
Palliative Care
Funeral Services
Doula
Counselling
Creative Services
Education
Ceremony
Administrative
End of Life wishes
Health
Other
SELECT: BUSINESS OR NOT FOR PROFIT
Please Select
NFP
BUSINESS
SOLE TRADER
Address
*
Street Address
Street Address Line 2
Town/City
State
Postcode
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Phone Number
Mobile Phone
*
E-mail
*
example@example.com
facebook
name of your business account
instagram
name of your business account
website
website URL
Exhibition Preferences
EXHIBITOR INFORMATION: Briefly describe the products/services you will be exhibiting
*
Table Preferences
Not for profit- table $45
1 standard table (180cm) BUS $85
2 standard tables (2 x 180cm) $120
Large Corner Spaces (limited to 2 spaces) $150
Special Requests and info
Do you need tables, Will you bring your own tables? Do you need power, are you bringing large exhibits etc
Add any additional comments, special notes
Social Media and Promotional Materials: Exhibitor information
For the organisers to promote you through the event: Please share a short biography and/or description about you or your services for promotional use. Highlight any special/ unique things about what you do
*
2 paragraphs / 250 words
Upload good quality images that showcase your service. This will to be used for promotion relating to the expo and social media campaign.
Browse Files
Drag and drop files here
Choose a file
images no larger than 3MB
Cancel
of
Upload good quality images to be used for : This will to be used for promotion relating to the expo and social media campaign.
Browse Files
Drag and drop files here
Choose a file
images no larger than 3MB
Cancel
of
Upload your LOGO
Browse Files
Drag and drop files here
Choose a file
images no larger than 3MB
Cancel
of
please tick any ways you will support the expo
distribute flyers
put posters up in my area
share and promote on my social media channels
be a media spokesperson for interviews
send out invitation in my monthly e-mailer
help set up on the day
photography
social media posts
Other
Speaker Application
what format would you like to be a part of
Please Select
part of a panel discussion
deliver a keynote talk (10-15 minute)
run a workshop (60 minute or more)
TALK PROGRAM: Speaker or Workshop Proposal : Outline your idea/proposal
would you like to be a speaker? Outline your proposed workshop or talk, including theme, duration
Terms and Conditions
By submitting this form, I agree to abide by the rules and regulations set forth by the event organizers.
I understand that my registration is subject to approval by the event organizers and that table assignments and speaker slots will be made based on availability and suitability.
I understand that confirmation will occur upon final payment
Signature
Submit
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