2025 EXHIBITOR REGISTRATION FORM 43nd Annual South Central Joint Mine Health & Safety ConferenceApril 7-9, 2025 ~CHOCTAW CONFERENCE CENTER ~ Durant, OK NOTE: Each TABLETOP booth includes one draped table (6 or 8 ft table), two chairs, all draping will be black. IF YOU PREFER A DIFFERENT ARRANGEMENT please specify below; we will notify you if there is an additional charge to accommodate your special needs:Company Name:* Company Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Primary Person (Point of Contact):* First Last Email* Phone*Description of Company*Please provide a brief description of services and / or products the company offers as soon as possible to post to our "2025 LIST OF EXHIBITORS". This includes website, mailing address you wish to have listed, Phone number and email address FEES:Booths : $895 /each Quantity*Basic Fee includes One Participant Registration per booth includes all meals & refreshments served by the Conference, including attending any sessions or workshops. DISCLAIMER: By Registering for the conference, you understand photographs will be taken and used on our website. All Company and personal information will be protection. WE DO NOT SHARE ANY LIST OF PARTICIPANTS. Thank you for your support!! Price: $895.00 Quantity Requested Booth Numbers* Please list the booth or booth numbers requestedAdditional Participant: $375 each QuantityIncludes all meals & refreshments served by the Conference, including attending and any sessions or workshops. DISCLAIMER: By Registering for the conference, you understand photographs will be taken and used on our website. All Company and personal information will be protection. WE DO NOT SHARE ANY LIST OF PARTICIPANTS. Thank you for your support!! Price: $375.00 Quantity There are 20 table top booths available first come first served. All booths are priced at $895.00 Please Use online form for both fees. DEADLINE TO REGISTER FOR A BOOTH IS March 1, 2025. Booths must be PAID IN FULL to be added to our website Exhibitor Hall Diagram By registering for the conference, you understand photographs will be taken and used on our website. REQUIRED FOR NAME BADGES:Name & Title of each AttendeeCard Billing InformationName* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Total Due $0.00 Credit Card CommentsThis field is for validation purposes and should be left unchanged. Have questions? Contact Us