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VENDOR

United Shoe Retailers Association

MAY EVENT SPONSOR APPLICATION

USRA May Event 2012 - May 1, 2, & 3

ROOM 1

Company Name:
Website:
Address:
City/State/Zip*:
Phone:
Fax:




Your Name:
Email:

If different than company numbers:

Your Address:
City/State/Zip:
Your phone:
Your Fax:
Arrival Date:
Departure:
Spouse
Sibling
Child
Parent
Friend
Co-Worker
Title:
Name:
Email:

If different from Attendee #1:

Address:
City/State/Zip :
Phone:
Fax:


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United Shoe Retailers Association

MAY EVENT SPONSOR APPLICATION

USRA May Event 2012 - May 1, 2, & 3

Company Name:
Single Occupancy
Non-Smoking
King
Double Occupancy
Smoking
Two Doubles
**Saturday (04/28/12) Arrival - an additional $189 plus tax will apply
**Sunday (04/29/12) Arrival - an additional $189 plus tax will apply
**Monday (04/30/12) Arrival - an additional $189 plus tax will apply
**Friday (05/04/12) Departure - an additional $189 plus tax will apply


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Next Page

United Shoe Retailers Association

MAY EVENT SPONSOR APPLICATION

USRA May Event 2012 - May 1, 2, & 3

Company Name:

ROOM 2





Your Name:
Email:

If different than company numbers:

Your Address:
City/State/Zip :
Your phone:
Your Fax:
Arrival Date:
Departure:
Spouse
Sibling
Child
Parent
Friend
Co-Worker
Title:
Name:
Email:

If different from Attendee #1:

Address:
City/State/Zip :
Phone:
Fax:


Back
Next Page
United Shoe Retailers Association

MAY EVENT SPONSOR APPLICATION

USRA May Event 2012 - May 1, 2, & 3

Company Name:
Single Occupancy
Non-Smoking
King
Double Occupancy
Smoking
Two Doubles
**Saturday (04/28/12) Arrival - an additional $189 plus tax will apply
**Sunday (04/29/12) Arrival - an additional $189 plus tax will apply
**Monday (04/30/12) Arrival - an additional $189 plus tax will apply
**Friday (05/04/12) Departure - an additional $189 plus tax will apply


Back
Next Page
United Shoe Retailers Association

MAY EVENT SPONSOR APPLICATION

USRA May Event 2012 - May 1, 2, & 3


Company Name:

$4000 May Event 2012 Sponsor Fee

Total Enclosed $:
Check payable to:
USRA
Mastercard
Visa
Amx
Name:
Card Number:
Exp Date:
Security Code:
On Visa, MasterCard and Discover the security code is the three digits to the right of the credit card number in the signature area on back of the card.    On American Express, the security is four digits printed (not embossed) on the right front of the card above the credit card number.

Signature

Credit Card Billing Address:
Same as listed on Page one
See Below


Address:
City/State/Zip*:
For early arrivals/late departures credit card must be on file. It will not be charged unless you do not cancel in advance. NON CANCELLATIONS WILL BE CHARGED BY THE HOTEL



 

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