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Contact Name |
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| Contact Email |
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Contact Phone |
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Presenter's Name |
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Presenter's Email |
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Job Title |
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Company |
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Mailing Address |
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| City |
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| State/Province |
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| Postal Code |
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| Country |
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| Phone |
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This info will be used on
the web, in the binder and on brochures... |
| Brief title of
your presentation (3 to 6 words-60 characters):
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Full title of your presentation
(5 to 10 words - 115 characters and spaces):
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Longer description of your presentation
(2 to 4 sentences, up to 255 characters and spaces) for use in advertising: |
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Do you authorize us to distribute your presentation after the seminar as a PDF file? |
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Comments or questions?
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Vendors: |
Since we will
be advertising your company in on our newsletter, post
card, brochure, seminar web page, and coking.com home
page and including you in our printed seminar handouts,
we require confirmation and payment in advance for the
company presentation or exhibit. Additional company
presenters can be
registered and paid
at your convenience. |
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How to Pay: |
Checks: We prefer you register on-line, but 1)
You may print a copy of this form and submit it with
your check, and/or 2)
create an invoice/receipt now.
Mailing Address:
Coking.com LLC
1410 Lowe Ave.
Bellingham, WA 98229
Fax: 1.866.854.6267
Phone (US)
1.360.966.7251 pst or 360.966.0447
Phone (CA)
1.403.668.7467
Phone (UK)
44.(0)2081.503669
Credit Cards: Pay
online
securely with Visa, Mastercard or AmEx. |
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By attending the seminar, you allow Coking.com, LLC
to use your photo and comments in marketing and
promotions. |
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