Connect & Emerge Sponsor & Exhibitor Registration
Business Name *
Contact Person *
Email Address(es) (include all who need to be copied on exhibitor emails, separate multiple email addresses with commas) *
Phone *
Mailing Address (include city, state, and zip) *
Facebook Page (if applicable)
Products or services you are promoting at the Conference *
Level of Participation *
Payment will be made by: *
Any special requests or needs?
Thank you for joining us for the Connect & Emerge Conference!
Contact Jennifer Clark with any questions you may have: or 601-270--2756.
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