Grad School Fair Exhibitor Registration Form

Complete this online form and make payment via check, purchase order or credit card to:

ASHA
American Speech-Language-Hearing Association
P.O. Box 1160 #450
Rockville, MD 20849
Fax 301-296-8568

Exhibitor Registration Fee: $150.00 per day
Early-bird Registration Fee: $100 per day when registered by August 29, 2008
Deadline to Register: October 17, 2008
Exhibitors MUST register for the ASHA Convention!

For more information, contact Dawn Dickerson at ddickerson@asha.org or 301-296-8705.

My program is:

My program is exhibiting:

University Name

Degrees offered (check all that apply)

Contact Information:

Instructions for Exhibitor Registration Payment

There are several options for making payment:

1) Send your credit card information via e-mail to Dawn Dickerson at ddickerson@asha.org. Include:

Name of cardholder
Credit card number
Expiration date

2) Print a copy of the GSF Exhibitor Registration Form and mail the copy along with a check, credit card information, or a purchase order to:

ASHA
American Speech-Language-Hearing Association
P.O. Box 1160 #450
Rockville, MD 20849

Also, include the e-mail address where the confirmation of payment should be sent.

3) Print a copy of the GSF Exhibitor registration form and send the copy along with your credit card or purchase order information via fax to 301-296-8568, Attention: Dawn Dickerson.

4) Call Dawn Dickerson at 301-296-8705 and provide credit card information or purchase order information to Dawn over the telephone.

For more information, contact Dawn Dickerson at ddickerson@asha.org or 301-296-8705.