To complete your registration
please complete the form below...

I would like to be an exhibitor in the Energy EXPO

         Please reserve booth(s) for me
        I would like to request an over-sized booth

        I need electricity   Yes  No 

       Special Requests:

        My company will provide  
        (i.e. informational pamphlets, giveaways, raffles, demonstrations,
               workshops, seminars, etc.)

Company Name:
Contact Person:
Phone:
Email:
Payment Options Include:
Payment Method:	Please Select One Visa MasterCard AMEX Discover Check Being Mailed Please Invoice Me
Name of Cardholder:
Acct No.
Exp. Date:
Billing Street Address:
Billing Zip Code:
3-digit Security Code  (on back):
Total Amount:                 $

  I understand that I must complete, sign and return a "Terms & Conditions"* sheet to Beacon Communications, 1944 Warwick Avenue, Warwick, RI 02889. Phone  401-732-3100   Fax 401-732-3110

*Original signature must be provided prior to setting up booth.