Please use the "Tab" key or mouse when moving from field to field.  Pressing the "Enter" key will automatically submit the form.

Please provide the following company information:

Name of Company
Contact Person
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Work Phone
FAX
E-mail

Please provide the following attendant information (if attendee is a P.E. and/or P.S., please indicate that after the name):

Name
Title
Name2
Title2

Please list/describe the service(s)/product(s) and/or specialization provided by your organization.  Also list company or companies you do not wish to be near.

FOLLOW LINK TO HALL LAYOUT CHARTS WHEN CHOOSING YOUR LOCATION ~ Crowne Plaza North Hotel

	1st Choice
	2nd Choice
	3rd Choice

No Yes Electrical Outlet (110 electrical outlet only is included - for electrical questions/telephone lines or high speed internet contact the hotel's electrical engineer at 614/885-1885 x252)

 CEAO cannot be held responsible for damaged, lost or stolen equipment.

After form has been received by the CEAO, you will be contacted regarding your table-top assignment and setup details.  For phone lines or internet connections contact the Crowne Plaza North Hotel.  For any and all electricity, you must mark "Yes" above on this form where requested.  You must bring your own extension cords and multiple plug strips.  Depending on your needs, there may be an additional setup charge by the hotel.  Display space is $295 each.  CEAO Supporting Members will receive a $50.00 discount.  Dee Bickers will be your Trade Show Coordinator (614) 221-0707.  If you have any questions regarding the Trade Show, please feel free to contact her at the CEAO office.  To ensure a booth, return this form immediately.

Trade Show Registration Deadline:  February 22, 2012

County Engineers Association of Ohio

6500 Busch Blvd., Suite 100, Columbus, OH  43229-1758

PHONE: 614/221-0707  - FAX: 614/221-5761 - E-Mail: dbickers@ceao.org

Please print this form for your records prior to hitting the Submit button.