2013 OSHP Annual Meeting
Vendor Showcase Registration Form

Friday, April 12th, 2013
St. John Medical Center
Mary K. Chapman Health Plaza
1819 E. 19th Street
Tulsa, OK 74104

Company Name:
Company Products:
Representative's Name:
Mailing Address:
City, State, Zip:
Telephone #:
Fax #:
E-Mail Address:
Please reserve in our name display space(s) at $500 per space.
Booth assignments are made randomly to assure that everyone has an equal opportunity for exhibit locations and will be available at the site on the day of the meeting. Covered display tables will be available on site.

If electrical outlets will be needed, please indicate the number of outlets that will be required. Please bring suitable extension cords if electricity is needed.
our display will require electrical outlets.
Please select payment method:

Comments/other special reqirements

Mail this form and fee (payable to OSHP) by Monday, April 1st
P.O.Box 2371
Oklahoma City, OK 73101-2371

OSHP Tax ID#: 73-1043506

For more informaiton contact Lisa Mayer.
Completed forms may be faxed to Lisa at - 405-307-1948.

For credit card registration via Pay Pal, click the appropriate button

Exhibit Space ($500)
Exhibit Space ($1000)
Exhibit Space ($1500)
Exhibit Space ($2000)

If you use Pay Pal, please also complete the above form and either mail it or fax it to us,
as Pay Pal does not collect the information we need.

Thank you for your support of OSHP!