Vendor Registration

Oregon EMS Conference

November X, 2023

LOCATION, Oregon

(sales pitch, how many attendees, how many day conference etc)

Company Name

Area Representative

Email *

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Phone

Cell or Direct Phone

Do you need a PDF'd invoice?

Vendor Opportunities *

Single Booth, 10’x10′ – $ 499.00
Double Booth, 16’x10′ – $ 899.00
Vehicle Space – $ 749.00
Provide Packet Materials (only) – $ 119.00

Total

$ 0.00

Stripe Credit Card

Card

Name on Card

If sending a check, please indicate the account holder's name & date check will be mailed. Please send checks to: Oregon EMS Association, PO Box 1118, Hillsboro, OR 97123

Purchase Orders not accepted.

To pay by check, make checks payable to:
OEMSA Oregon EMS Association

Send Payment and a copy of this completed registration form to:
Oregon EMS Conference
PO Box 1118
Hillsboro, OR 97123

For additional information please contact XXXX.