Vision Quest Conference

200-208 Edmonton Street
Winnipeg, MB R3C 1R7
Phone: 204-942-5049 | Fax: 204-237-8991 | Toll Free: 1-800-557-8242
Email: admin@vqconference.com

Exhibitor Registration Form

Organization Information

Company*
Type of product or service*
Website*
Mailing Address*
City/Town*		Province*
Postal Code*

	Primary Contact Person Only the primary contact person will receive receipts and exhibitor registration details.
First Name*		Last Name*
Phone*		Fax*
Email*		Confirm Email*

	Exhibitor Options
Exhibit Opportunities*
# of Booths*		Booth Preferences	1. 2. 3.

Payment Information

All registered exhibitors must be paid in full prior to the conference.

Payment Type	Credit Card Information
VISA	Name On Credit Card
MasterCard	Credit Card Number	No spaces, numbers only
AMEX	Credit Card Expiry
Cheque

* - Required Field


DAKOTA OJIBWAY CFDC	KITAYAN CFDC	SOUTHEAST CFDC	CEDAR LAKE CFDC	NORTH CENTRAL CFDC

Exhibitor Registration Form

Organization Information

Primary Contact Person

Exhibitor Options

Payment Information

Payment Type

Credit Card Information