Event: _________________________________________________________________

Name of Association: _____________________________________________________

Address: _______________________________________________________________

Contact Person: _________________________________________________________

Telephone#: _______________________ Cell#: _______________________________

Fax#: ___________________________ 

Email: _________________________________________________________________

__________ # of Members Attending

__________ # of Non-Members Attending

Names: _______________________________________________________________

______________________________________________________________________

______________________________________________________________________

Vendor Information:

Name of Association or Firm: _____________________________________________

______________________________________________________________________

Address: ______________________________________________________________

______________________________________________________________________

Telephone#: _______________________ Cell#: ______________________________

Fax#: ___________________________ 

Email: ________________________________________________________________

Additional Equipment Required: ___________________________________________

_______________________________________________________________________

For additional information contact Marilyn Jeffers, Program Chair @ 1-888-644-6480, 1-804-644-6404 or Email eventinfo@cvccai.org