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 NameLast Name
Address for materials to be shipped to*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What type of address is this
Email*
example@example.com
Phone Number*

Area CodePhone 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. Materials available include, NBCSN Ribbons, NBCSN Liaison Ribbon, NBCSN Certification Brochures and NBCSN Recertification Brochures. Please select your what you would like for the booth.
Please select other materials you would like to have available at your booth and if you require NBCSN to pay the vendor fee and honorarium.

NCSN RibbonsNBCSN Liaison RibbonNBCSN Certification/Recertification BrochuresNBCSN PensTable top BannerVendor Fee*$100 Honorarium**
*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:

NBCSN State Liaison Materials Request

Conference Information

Materials Needed Information