Exhibitor/Vendor Registration Form
This form may be completed online and submitted electronically by clicking on the submit
button below. This form is for exhibitors paying registration fee by credit card. Those choosing
to mail registration fee may download and print Registration Form and mail with payment.
After completing and submitting form, pay registration fee using your credit card by clicking on
the Pay Pal button below. Pay Pal is a secure payment method. If you plan to attend the
conference, please go to Presenter/Exhibitor Registration page to register.
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2011 Oklahoma Indian Child Welfare Conference
"Improving Outcomes for Indian Children Through Policy, Practice, and Partnerships"
Dates: November 14-16, 2011
Exhibit Registration Fees:
• $50.00 per booth • $75.00 per booth w/ electrical outlet • $20.00 Take-One Table
Cancellation: $20 of the exhibit fee is non-refundable. The remainder of the exhibit fee will be
refunded if written notification of cancellation is received by OICWA no later than Oct 31, 2011.
OICWA reserves the right to reject any application to exhibit. Full refund will be provided if
application is rejected or not selected due to no space available.
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Your Name:
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Job Title:
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Agency/Organization/
Business Name OR
Tribal Affiliation if
Native Artist:
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Mailing Address:
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City/State/Zip:
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Phone Number:
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Email Address:
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Web Address:
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Description of services/
products to be exhibited:
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Exhibit Type:
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Booth: Includes one 6 ft. table draped and skirted, one trash can, and two chairs
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Booth w/ electrical outlet: Includes items listed above & access to electrical outlet
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Take-One Table: Provide OICWA with your publications (e.g., brochures,
literature, sales fliers, etc.) and OICWA will display for you.
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Please click Submit after completing fields. Submission is not complete until you are
directed to a confirmation web page screen. To pay registration fee with a credit card,
click on the corresponding PayPal button for selected Exhibit Type located on the
confirmation web page screen.
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ATTENTION: Native American Artists. If you would like to donate an item or items in lieu of
paying the exhibit fee, please check box and describe item:
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I am donating the following item(s):
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Submission Deadline: September 15, 2011 EXTENDED TO OCTOBER 31, 2011
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