Southeast NM Business Forum Registration Form

Southeast NM Business Forum Registration Form
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Job Title*
Company/Organization Name*
Company Location (City, State or Country)*
Primary Company Industry

ConstructionEnergyInformation TechnologyManufacturingMiningProfessional ServicesOther
Media Authorization Acceptance*

Photography and recording will take place at this event. By entering, you grant Salado Isolation Mining Contractors, LLC permission to use your likeness in photographs, videos, or other digital media for any lawful purpose, including marketing, website, and social media. If you do not wish to be photographed, please inform the event organizers at the registration desk.
Would you like to be a sponsor?

YesNoNot Sure
Select the sponsor level you would like to be.

Platinum - $3000Gold - $2000Silver - $1000
Select the events you are interested in participating in

WIPP Tour at WIPP Site - Tuesday, July 28 (Morning)Mixer Event - Tuesday, July 28 (Evening)Golf Tournament at the Lake Carlsbad Golf Course (All Day)
*WIPP Tour is RESTRICTED CAPACITY: This event is limited to sponsor attendance only, with a 30 person capacity. One attendee per sponsor will be permitted attendance.

**Golf Tournament is LIMITED CAPACITY: Only the first 90 people interested will be registered for this event. Fee of $100/person.
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