Retailer Registration - 2008 HWBTA Conference

This form is for MAIL-IN or FAX-IN ONLY - you may also register online (available 1 May).

FRIDAY, June 6 - MONDAY, June 9, 2008

BWI Airport Marriott Hotel
Baltimore, Maryland

Company Name __________________________________________

Address ________________________________________________

                ________________________________________________

Phone No. ______________________________________

E-mail address __________________________________

Attendees (please list names individually and PRINT clearly)

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

Please check here (   ) if this is your first conference.

Fees listed below are PER PERSON

We accept checks, cash, money orders, and major credit cards for payment.

Credit Card # __________________________________________
                         Exp. ______________         Amount ______________

Name on Card: ________________________________________

NOTE: Make checks payable to HWBTA & mail to P.O. Box 1373, Valrico FL 33595
Or FAX this form to 813-681-5625.

REFUNDS - Full refund (less $10.00 USD processing fee) until 1 June 2008.

We take your privacy very seriously and we never sell, rent or otherwise distribute the information you submit on our website. You can rest assured that your personal information, including your email address, will be kept in strict confidence. Furthermore, in the interest of your security, your credit card number and expiration date is not stored on our servers.

WHOLESALERS/EXHIBITORS - please use wholesaler/exhibitor registration form.

Please note: 2008 dues must be paid to qualify for "member" fees.