Clinic Application For Exhibit Space

Please be aware of important deadlines:

April 15th — you must be registered and paid to be included in the MCA Clinic brochure — submit your online form and mail check or pay online by this date
July 15 — final deadline to reserve a space at the 2024 MCA Clinic — submit your online form and payment by this date

Firm Name*
Company Contact*
First Last
Phone*
Email*
Rep #1
First Last
Rep #2
First Last
Mailing Address*
Mailing address City State ZIP Code
RATES
10X10 Booth- $250.00

Additional Spaces- $175.00

If application and full payment are received by 4-15-24, you will be listed in the Clinic Brochure.

DEADLINE FOR APPLICATION and FULL PAYMENT: JULY 19th, 2024 (Spaces will not be reserved and set up without full payment). CANCELLATION DEADLINE is JULY 20th. Prior to cancellation deadline date, $50 (per space) is non-refundable. If you cancel after the cancellation deadline, you are responsible for the entire fee. Cancellations must be made by phone followed by e-mail.
How would you like to pay?*
To reserve a space, payment must be received no later than July 16.

Online

Mail a Check (to be cashed after June 1)
Payable to:
MCA, 375 Ramble Inn Rd., Fort Shaw, MT 59443
Initial Space*
Price:
Additional Space Quantity
Price: $175.00
Online Fee
A small expense has been added to your registration fee to cover the online processing fees from PayPal.
Price: $0.00
Arrival Date*
MM slash DD slash YYYY
Departure Options*
Exhibits will close at noon this year. Please plan to keep your booth open until then. Those wanting to stay longer please contact Marian Olsen.

Plan to stay until Noon on Thursday

Plan to leave early

Would like to stay later
Special Requests
If you need electrical power, please bring your own cord. Any space needs beyond your booth must be approved in advance.
Drawings and Door Prizes
Are you interested in participating in a booth drawing and/or door prize give away to help promote your business?*

Booth Drawing

Door Prize

Both

No
Item(s) you wish to give away at booth drawing:
Approximate Retail Value
Item(s) you wish to give away for door prize:
Approximate Retail Value
Promo
For those registering before June 15th, we invite you to send us a 1-2 sentence promo line and your business logo. We will include this info on our website vendor list.
Add your Logo
Max. file size: 12 MB.
Payment
Total Amount Due
$0.00
Payment Method*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

Clinic Application For Exhibit Space

RATES

Drawings and Door Prizes

Promo

Payment