NBCSN State Liaison Materials Request

NBCSN State Liaison Materials Request

All conference material will be mailed to you prior to conference (subject to availability). Request must be received no later than one month before conference. All information MUST be filled in.After the conference, you must return the display, brochures, ribbons and booth attendee list, within 48 hours of the completion of the conference. Instructions for return and a mailing label will be included.
Name *

First Name Last Name

Address for materials to be shipped to *

Email *
example@example.com
Phone Number

- Area Code Phone Number
Conference Information
Conference Name *
Conference Location *
Conference Date(s) *
Expected Conference Attendance *
Materials Needed Information

Please select which materials you would like for the conference. All materials will be sent with subject to availability.
Vendor Fee* $100 Honorarium** NBCSN Floor Display NBCSN Tablecloth NBCSN Ribbons NBCSN Liaison Ribbon NBCSN Certification Brochures NBCSN Recertification Brochures
*A Vendor Fee, up to $150, will be paid by NBCSN. Please send the application to info@nbcsn.org. The check will be mailed to State or Conference Treasurer.

**$100 Honorarium will be paid upon receipt of a completed State Conference Sign Up Sheet, a copy of your attendance certificate and any unused materials and display items sent to you.
Should be Empty:

Conference Information