Vendor Registration

Organization *

Address *

City *

State *

Zip *

Phone Number *

Email Address *

Company Representative
(One registration is included with the exhibitor registration fee; other representatives are $100.00 per representative)

Number of Representatives *

Last Name #1

First Name #1

Title #1

Last Name #2

First Name #2

Title #2

Last Name #3

First Name #3

Title #3

Last Name #4

First Name #4

Title #4

Last Name #5

First Name #5

Title #5

Last Name #6

First Name #6

Title #6

Last Name #7

First Name #7

Title #7

Company representative attending the conference (One registration is included with the exhibitor registration fee; other representatives are $100.00 per representative)

Booths and Sponsors

Indicate the number and/or type of booth or sponsor:

Star of Life Sponsor @ $6000.00

Diamond Level Sponsor Booth @ $5000.00

Platinum Level Sponsor Booth @ $4000.00

Gold Level Sponsor Booth @ $3000.00

Silver Level Sponsor Booth @ $2000.00

Bronze Level Sponsor Booth @ $1000.00

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Conference Booth and extras

Exhibitor Booth @ $650.00

# of additional tickets/for Friday evening @ $30.00

Electricity for booth @ $25.00

Additional Sponsorship

Vendor Bingo and Mash Bash Competition Winner Prizes (I-pad, Smart TV, i.e.) @ $1,000

Conference materials (Name Tags, Programs, i.e.) @ $400.00

Company Ad on LANREMT website for a year, with link @ $500.00

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Additional Items

Early Morning Coffee @ $300.00

Break Out Session Refreshments @ $300.00

Gift Card(s) door Prizes each-----------(@$100.00 per card)

Morning Break refreshments (in Exhibit Hall)-@ $500.00

Afternoon Break refreshments (in Exhibit Hall @ $500.00

Statments

Conference Program Exhibitor Listing: *

By completing this application, I agree to the following terms and conditions.

I representing agree to the terms of this Exhibitor Contract, and do plan to send a Company associate(s) to attend the One Mission: One Team Conference as an Exhibitor during June 6-8 2024. I agree to pay in full the total amount due as indicated in this document. If the total amount due is not included in this Exhibitor Contract, I agree to remit the total amount due by May 15, 2024. Any Exhibitor Contracts not paid in full by May 15, 2024, will not be binding. Exhibitor Contract mailed after May 15, 2024, will not be considered binding until paid in full. The number of Exhibitor spaces is limited and Exhibitor Contracts will be issued on a first paid basis. Mail contract and payment to 2024 EMS Conference, Attn: Shanna Ellis, PO Box 126, Bentley, LA 71407. Make check payable to the Louisiana Association of Nationally Registered EMTs. The completed contract can be sent via email or regular mail.

Payment

Additional Attendees

Booth or Sponsor

Conference Booth and extras

Additional Sponsorships

Additional Items

Conference Total

Method of Payment for Conference *

Make check payable to Louisiana Association of Nationally Registered EMTs

Mail contract and payment to:

2023 EMS Education Conference and EXPO

Attn: Shanna Ellis, PO Box 126, Bentley, LA 71407.
(318) 229-6515

conferenceregistration@lanremt.com