2017 Book Fair Exhibitor Registration
(Application MUST Be Typed)
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Company Name: *
(Author Name Acceptable If No Company Name)
Type: *
Contact Person: *
Company Address: *
City: *
State: *
If not located or based in the United States, please specify your full address in the "Other" field below
Zip Code: *
Other
If not located or based within the United States, please provide your full address below
Phone Number: *
(Home or Business)
Cell:
Fax:
Website:
Email: *
Please note that we communicate through e-mail. Make sure you provide us with a valid e-mail address that you check on a regular basis, and that you add Ghernan3@mdc.edu,  Rjimene4@mdc.edu and Zachary.Fetaru@img.com to your contact list to avoid any of our emails being sent to your spam folder.
Federal ID# (For Florida Tax Collection) *
If no Federal ID#, exhibitor must provide Social Security Number upon submitting payment
Booth Name: *
(Please provide exact name to be listed in the Fairgoer's Guide and on booth signage. Note that no changes will be accepted).
Detailed Description of Your Exhibit (Your Application will not be considered if this field is not completed): *
Please provide a brief (100 word maximum) description of the books you will be exhibiting at your booth. Please send any newspaper articles or marketing information you might have regarding our books.
Please select ONLY ONE: *
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