DEADLINE: June 1, 2004

Company Name for Badge(s):

Check here if a previous Pre-Registration Form was submitted.

Executives & Company Personnel:
All non-selling attendees listed below will be mailed badges to the contracting member at the address provided on the exhibit contract.

1. Full Name: Title:
2. Full Name: Title:
3. Full Name: Title:
4. Full Name: Title:
5. Full Name: Title:
Sales Representatives & Account Executives (WSA Members):
Current WSA Members listed below will be mailed their badge individually to their membership address. Please note pre-registration does not update your membership listing. Submit separately, in writing, any address or company changes or submit changes online here.

1. Full Name: WSA#:
2. Full Name: WSA#:
3. Full Name: WSA#:
4. Full Name: WSA#:
5. Full Name: WSA#:
Your email address: (in the event questions arise with this form)
Telephone Number:
Members Only: Please inform us of any changes in your membership information (i.e. address, name change, email, phone, etc.) with the form here: Update Membership Form