2019 BrandExpo-Bloomington, Indiana Supplier Registration

Tuesday, October 8, 2019

Supplier Line Name*
Supplier Corporate Mailing Address*
Address Line 1 Address Line 2 City State / Province / Region ZIP / Postal Code Country
Attending Representative's Full Name*
First Last
Please list the attending supplier contact's full name
Attending Representative's Email*

Please list the attending supplier contact's email address - all communications regarding the Brandexpo will be directed to this email.
Attending Representative's Phone Number*
Please list the attending supplier contact's phone number
Second Attendee Name, if applicable
Second Attendee Email, if applicable
Invoice Contact Full Name
Invoice Contact Email
Invoice Contact Phone Number
Number of Booths*
- One for $250.00
- Two for $450.00
- Three for $675.00
- Four for $900.00
NOTE: Due to space limitations, each booth is allowed only ONE table; two booths allows for two tables; three booths allows for three tables, etc. If you would like more than one table, you will need to purchase more than one booth.
Select Desired Payment Method*
Miscellaneous Instructions
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