Exhibitor Registration
Form
32nd
Annual Occupational Safety and Health Summer Institute
Marriott Norfolk Waterside
Norfolk, Virginia
Tuesday, August 4, 2009
Exhibitor's
Name ________________________________________________________
Exhibitor's
Name ________________________________________________________
Organization
or Firm _____________________________________________________
Address _______________________________________________________________
City State Zip __________________________________________________________
Business Phone _________________________________________________________
Business Fax ___________________________________________________________
Product(s) Exhibited _____________________________________________________
E-mail Address
__________________________________________________________
Exhibitors
Registration Fee $250: Please use one of the following methods
of payment:
Check enclosed
(payable to UNC-CH) _____
Please charge
to: _____ Mastercard _____VISA
_____ Diners Club
Please print name on card ___________________________________________
Card Number
_______________________________ Exp. Date _______
Signature:_________________________________
The Registration
Fee will include:
- One draped
table in Exhibit Space, Two chairs
- Electrical
Outlet (will you need) YES _____ NO _____
Please plan
to set up prior to 10:00 am on August 5.
- Morning break
10:00 am - 11:00 am
- Lunch
11:30 am - 1:00 pm
- Afternoon
break 2:30 pm - 3 :30 pm
- Reception 6:00 - 7:00 pm
Send registration form with payment to:
NC OSHERC
PO Box 16248
Chapel Hill, NC 27516-6248
888-235-3320
Fax: 919-966-7579
osherc@unc.edu |