New Exhibitor Application for INSURCON

Basic Application Information
- Company Name *
- Booth Signage - how would you like your company name to be displayed at the event, booth, marketing, and badge information? *
- Website
- Bus. Category *
  
  Bus. Category (Other)
Primary Exhibitor Contact
This individual will receive the attendee list, exhibitor toolkit and e-blasts.
- Primary Contact *
  
  Phone *
  
  Email *
Exhibitor Billing Address
- Street 1 *
  
  Street2
  
  City *
  
  State *
  
  Zip Code *
Description of Products and Services
- Description *
List any competitors you do not want at adjacent booths.
If no preference is listed, booth(s) will be assigned by IIAT.
- Competitors List
Preferred Booth Assignment
Booths are assigned on a first-come, first-served basis. If your choices are not available, IIAT will assign the nearest available space.
- Number of Booths *
- Booth Choice 1 *
  
  Booth Choice 2
  
  Booth Choice 3
  
  Booth Choice 4
  
  Booth Choice 5
- Booth Special Requests/Comments
Complimentary Full Exhibitor Registration
With your booth purchase, you receive one complimentary full registration. This admits the badge holder to all conference events. Who will receive this registration?
- Full Name *
  
  City, State *
  
  Email *
Trade Show only passes
With your booth purchase, you receive three Trade Show only passes. Who will receive this registration?
- Pass 1 Full Name
  
  Pass 1 City/State
  
  Pass 1 Email
- Pass 2 Full Name
  
  Pass 2 City/State
  
  Pass 2 Email
- Pass 3 Full Name
  
  Pass 3 City/State
  
  Pass 3 Email
For INSURCON, Additional Registrants are $50 Trade Show Pass and $295 Full Exhibitor Registration.
You may purchase up to six (6) additional registrations per booth.
IIAT recommends you make all purchases in advance to avoid delays in entering the Trade Show.

To register additional attendees, please contact exhibits@iiat.org and include:
  > first and last name
  > city and state
  > email
  > type of badge (Exhibitor or Trade Show Pass)

An invoice with the additional amount due will be emailed.