The WSA Show
Exhibitor Pre-Registration Form
February 10 - 13, 2004

DEADLINE: October 1, 2003
Company Name for Badge(s):
Check 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.
01.Full Name: Title:
02.Full Name: Title:
03.Full Name: Title:
04.Full Name: Title:
05.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 on-line here.
01.Full Name: WSA#:
02.Full Name: WSA#:
03.Full Name: WSA#:
04.Full Name: WSA#:
05.Full Name: WSA#:
Return e-mail: in the event questions arise with this form
Please enter any comments below.
Members Only:
Please advise of changes in your membership
(address, name change, e-mail, phone, etc.)
with the "update membership" form below:

Once you have completed this form, submit by hitting the SUBMIT button below or you can print it out by downloading the form and printing out then fax or mail it to:

WSA Registration Headquarters
PO Box 52170
Irvine CA 92619-2170
Fax: 949-475-1765
© WSA 1999-2004. All Rights Reserved.