Eastern Exposition for Cleaning Professionals

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Registration Form On-site Registration Sponsored by | (Complete ONE form per company and submit a business card for each company attendee. Deadline for pre-registration is April 30, 2010.) PRIMARY CONTACT NAME | COMPANY | ADDRESS | CITY | PHONE | FAX | STATE Registration Fees — NJSSA & NESSA Member Registration NJSSA & NESSA Members receive 6 free registrations with their paid membership dues and may attend Supply Line 2010 at no charge. Membership dues for 2010–2011 must be paid to pre-register before April 30, 2010. This offer is not available at on-site registration. 2010–2011 NJSSA Membership Dues (6 attendees included with membership) $275 $__________ 2010 NESSA Corporate Member Dues $125 $__________ Additional Paid Member Registrants _____ @$ 25 per person $__________ Non-Member Registration Cleaning Professional _____ @$ 25 per person $__________ Distributor _____ @$ 25 per person $__________ Manufacturer Representative _____ @$ 25 per person $__________ Non-exhibiting Manufacturer | EMAIL | ZIP _____ @$960 per person $__________ Seminar/Event Fees (With paid admission, fees are per person) MEMBER NON-MEMBER TOTAL How To Reduce Cleaning Costs _____ @$ 25 _____@$ 50 $__________ (For distributors and cleaning professionals) ISSA CIMS I.C.E. Workshop: Register at www.issa.com/standard/ice Before April 23, 2010 (For distributors,and cleaning professionals) (For distributors and cleaning professionals) Golf Outing _____@$105 _____@$105 $__________ Awards Luncheon Only _____@$ 25 _____@$ 25 $__________ _________________________________________ ________________________________________ _________________________________________ ________________________________________ TOTAL DUE: Make Checks Payable to NJSSA $__________ Or pay by Credit Card ( ___Amex ___ MC ___ Visa ___ Discover) Card Number: ___________________________________ Exp. Date: _____________ CVV:_______ Name on Card: _______________________________ Signature: _____________________________ Billing Address: _____________________________________________________________________ City: ________________________________________ State: ____________________ Zip: ________ Supply Line 2010, NJSSA and NESSA are managed by Peak Management Solutions. All credit card charges will appear on your statement as Peak Management Solutions. Company Registrants: (Make additional copies of the registration form if needed.) _________________________________________ ________________________________________ 6) 7) _________________________________________ ________________________________________ _________________________________________ ________________________________________ 8) 9) _________________________________________ ________________________________________ _________________________________________ ________________________________________ 10) Company business: Distributor Buildings & Grounds Industrial Maintenance, State, or Federal Facilities Manufacturer Rep Cleaning Professional Other______________________ Non-exhibiting Manufacturer Executive Housekeeping RETURN REGISTRATION FORM TO: New Jersey Sanitary Supply Association P.O. Box 435, Butler, NJ 07405-0435 Or register online at: www.njssa.net 6 3) 4)
May 5 and 6, 2010 Taj Mahal Etess Arena Atlantic City, NJ NJSSA Supply Line 2010 P. O. Box 435 Butler, NJ 07405-0435
Page 1 and 2: R E G I S T R A T I O N B R O C H U
Page 3 and 4: Schedule Of Events Tuesday, May 4,
Page 5 and 6: Professional Education Exclusive op
Page 7: Exhibitors 3M Company A & B Wiper S

Eastern Exposition for Cleaning Professionals

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