EXHIBITOR PRE-REGISTRATION & ADDITIONAL BADGE REQUESTS

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:

Comments:

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