MARCUMS 2018 Conference
Business Partner registration for Online Payment.
Join us on October 16 & 17, 2018 at Bucknell University for the MARCUMS 20th Anniversary Conference.
Company
*
Representative Name
*
First Name
Last Name
Representative Title
Representative Email
*
example@example.com
Food Allergy
*
None
Other
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Additional Representatives
You may bring additional representatives for an additional fee.
Representative #2 Name
First Name
Last Name
Representative #2 Title
Representative #2 Email
example@example.com
Representative #2 Food Allergy
None
Other
Representative #3 Name
First Name
Last Name
Representative #3 Title
Representative #3 Email
example@example.com
Representative #3 Food Allergy
None
Other
Representative #4 Name
First Name
Last Name
Representative #4 Title
Representative #4 Email
example@example.com
Representative #4 Food Allergy
None
Other
Representative #5 Name
First Name
Last Name
Representative #5 Title
Representative #5 Email
example@example.com
Representative #5 Food Allergy
None
Other
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Online Payment
Please remember that Registration is not included in sponsorship. All sponsorship's include:Our Sincerest Gratitude - Signage and Recognition at the Sponsored Event - One Additional Company Representative (2 Total) - Advertisement in Our Conference Program - Advertisement in Our Conference Newsletter - Your Business Logo Displayed on the Conference Page of the MARCUMS Website.
Registration Fees
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Business Partner Registration Fee
$
200.00
Exhibitor Display Fee
$
75.00
Additional Representative
$
75.00
Quantity
0
1
2
3
4
5
Gold Sponsorship (Limit 3)
$
500.00
Quantity
0
1
2
3
Silver Sponsorship (Limit 3)
$
400.00
Quantity
0
1
2
3
Subtotal
$
0.00
Shipping
$
0.00
Total
$
0.00
Submit
Should be Empty: