2019 BrandExpo Supplier Registration-Burnsville, Minnesota-NP

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 $500.00
NOTE: Due to space limitations, each booth is allowed only ONE table.
Select Desired Payment Method*
Miscellaneous Instructions
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