Name *
Name
Phone *
Phone
Address *
Address
EXHIBITOR STAFF 1-2 representatives per table, CE will be given to two reps only
Staff 1
Staff 1
Is Staff 1 CE?
Staff 2
Staff 2
Is Staff 2 CE?
Support Level *
PLATINUM includes 2 tables, recognition on rotating slides, printed level recognition, premium exhibitor hall location.
GOLD includes 1 table, recognition on rotating slide, printed level recognition.
SILVER includes 1 table, printed level recognition.
EXHIBIT ONLY includes 1 table
Exhibit Information
We will need electricity *
We understand that signs, banners or decorations are not allowed in the aisles and exhibits may not obstruct the view of neighboring exhibits. *

MAIL PAYMENT TO:
(please include registered name on memo line)

Sleep Professionals of Arkansas
PO BOX 1748
Nashville Arkansas  71852

For Questions or Further information call:  JoAnn Hunt, RRT, RPSGT Phone 870 331-6256 Email SPAJoann@gmail.com and / orRodney Brazeal, RPSGT 501-794-8400
Email rbrazeal@smssleep.com

No refunds after February 11th, 2018. A $50 administrative fee will be assessed for all refunds.
ONSITE REGISTRATION MUST BE PAID BY CASH OR CHECK