EXHIBITOR REGISTRATION FORM
21st Annual National
Health Benefits Conference & Expo (HBCE)
January 31 - February 1, 2012
Sheraton Sand Key Resort - Clearwater Beach, FL
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SCAN FORM and E-MAIL to:
info at HBCE.com or FAX to:
941-484-1410
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EXHIBITOR FEES: Three Choices: $2,395 for a 10' (wide) x 8' prime or corner space; $2,195 for a 10' x 8' interior space;
or $1,995 for a 8' wide table-top space. All exhibit spaces include pipe and drape, a 6' draped table, 2 chairs, and
wastebaskets.
Registration also includes two (2) full access Conference registrations.*
Please contact HBCE at 941-484-1430 or info (at) HBCE.com and request the Exhibit Hall layout to select your space. Your
chosen space will be reserved upon receipt of payment.
>>>>>>>>>> Meet current and future clients. Join the best employer purchasers, peers and potential partners. <<<<<<<<<<<
Company Name_______________________________________________________________________________________
Two registrants* if known (name & title)_____________________________________________________________________
____________________________________________________________________________________________________
Address (for correspondence)____________________________________________________________________________
____________________________________________________________________________________________________
Contact Person (if different from above)____________________________________________________________________
Phone:__________________________________________________Fax_________________________________________
E-mail(s):____________________________________________________________________________________________
Please make CHECKS payable to: or pay by CREDIT CARD and mail or FAX to: 941-484-1410
Health Benefits Conference & Expo Credit Card: ( circle or check) MC___ VISA___ AMEX___
Card No.________________________________________
Send to: 500 The Esplanade, Ste. 205
Venice, FL 34285-1533
CVV # ( 3 #s on back), except AMEX ( 4 #s on front ):______
Phone: 941-484-1430 Exp. Date__________________Total $_________________
Fax: 941-484-1410 Signature_________________________________________
E-mail: info (at) HBCE.com Name on Card ____________________________________
*All Other Staff from your Company may attend @ $250 each. THANK YOU FOR YOUR PARTICIPATION AND SUPPORT
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TIN: 20-1571141