Clinic Application For Exhibit Space | Montana Coaches Association: Online Forms

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- $350.00

Second space- $250.00

If application and full payment are received by 4-15-26, you will be listed in the Clinic Brochure.

DEADLINE FOR APPLICATION and FULL PAYMENT: JULY 15th or when we are full. (Spaces will not be reserved and set up without full payment). CANCELLATION DEADLINE is JULY 24th. 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. Checks will be cashed after June 1

Online

Mail a Check to secure spot (to be cashed after June 1)
Payable to:
MCA, 375 Ramble Inn Rd., Fort Shaw, MT 59443

Initial Space*
Price:

Are you interested in purchasing additional space?*

Yes

No

Additional Space (only a total of 2 spaces allowed due to increased demand)
Price:

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*

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