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Pharmaceutical Vendor Fair – Registration

Please complete the form below to register for our upcoming Pharmaceutical Vendor Fair.

Pharmaceutical Vendor Fair Registration & Payment

"*" indicates required fields

Representative Name*

First Last

Company Name*

Company/Billing Address*

Street Address Address Line 2 City State ZIP Code

Representative Phone*

Representative Email*

How would you like your booth/company to be listed?*

Please let us know exactly how you want your company’s name listed/included on signage, flyers, and other communications.

Will you need an electrical outlet for your table?*

Payment Type*

*Only two reps allowed per table.

Pharmaceutical Vendor Fair Booth Registration Fee

Price:

Pharmaceutical Vendor Fair Booth Registration Fee*

*Includes credit card processing fees

Price:

Total

Thank you for helping us in our mission of Supporting a Healthier Coast!

If paying by check: Please make sure your check has accompanying details that include the date of the event and the company/rep name you are paying for and mail to: Singing River Foundation 3109 Bienville Blvd Ocean Springs, MS 39564

If paying by ACH: Please email Laura.Sessum@mysrhs.com to receive the ACH payment details.

Credit Card

Cardholder Name

Card Details

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