Ditchmen • NUCA of Florida Ditchmen - April 2021 | Page 60

NUCA OF SOUTHWEST Florida 2021 TRADE SHOW

You may join NUCA SWFL at time of registration and receive the 2021 Member booth rate .
Company Name : _____________________________________________________________________________________
[
] Booth NUCA SWFL Member $ 550 per booth
Number of Booths :_____
Amount _______
Member Only - Extra Booth $ 250
[ ] Booth Non-Member $ 750 per booth Number of Booths :_____ Amount _______ ***** Name of NUCA SW FL Member Sponsor :__________________________________________________________________
58 DITCHMEN • APRIL 2021
Booth #’ s – top ( 3 ) choices : 1 st Choice __________ 2 nd Choice _________ 3 rd Choice _________
Names of all persons working the booth : __________________________________________________________________________________________ _____________________________________________________________________________________________________________________________
Additional Persons at Booth _____ How Many :______ Amount __________ * Booth charge includes 2 exhibitors per booth , any extra cost is $ 25.00 per person
[ ] OTHER CHARGES _______________________________________________________________________ BOOTH HOLDERS CAN ALSO BE SPONSORS !
******************************************************************************************
Sponsorship Information [ ] PLATINUM includes 5 free tickets to show $ 500
[ ] GOLD includes 3 free tickets to show $ 350 [ ] SILVER includes 2 free tickets to show $ 300 [ ] BRONZE includes 1 free ticket to show $ 250
********************************************************************************************* Type of Credit Card :
Please print clearly – All info is required
_________ Visa _________ MasterCard _________ American Express Credit Card Number : ______________________________________________________________________________
Expiration Date : ____________________ V-Code :______________( V-Code is the last three digits in the signature strip on the back of the credit card for Visa / MasterCard , or the digits on front of card for American Express ).
Name on Card : _________________________________________________________________________________________ Company Name :_________________________________________ Print Name :_____________________________________
___________________________
_______________________________________
$_________________________
Phone #
Email Address
Total Amount to be charged
A receipt will be emailed to you when charges are made on your account . For security purposes , your credit card information will not be kept on file . New information will be needed for each new charge . Please forward completed form to : nucaswfl @ gmail . com or fax to 239 / 790-1369
Thank you for participating in the 2021 NUCA Southwest Florida Trade Show !!