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Please type or clearly print and complete all sections of this application. Mail completed application
with deposit to the National Propane Gas Association, P.O. Box 418496, Boston, MA 02241-8496
or scan and e-mail to expo@npga.org. Contact the National Propane Gas Associations Exposition
Management Department with questions at (630) 325-8910 or email expo@npga.org. The company
information provided below will be printed in all marketing materials produced for the 2013 Southeastern
________________________________________________________________________________________________________________________________________________________________
COMPANY NAME
________________________________________________________________________________________________________________________________________________________________
ADDRESS
________________________________________________________________________________________________________________________________________________________________
CITY STATE ZIP
________________________________________________________________________________________________________________________________________________________________
COMPANY PHONE COMPANY FAX
________________________________________________________________________________________________________________________________________________________________
COMPANY EMAIL COMPANY WEBSITE
The undersigned, as a duly authorized representative of the company, agrees to abide by the Terms and Conditions available for review on the website at www.PropaneExpo.com/
2013Terms. The contact name provided below consents to receive future correspondence, including faxes and emails, sent by the National Propane Gas Association (NPGA) and its
official service contractors.
________________________________________________________________________________________________________________________________________________________________
CONTACT NAME CONTACT TITLE
________________________________________________________________________________________________________________________________________________________________
CONTACT CELL PHONE CONTACT EMAIL
________________________________________________________________________________________________________________________________________________________________
SIGNATURE
Booths are assigned based on the order in which applications are received, number of
consecutive years exhibiting, booth size and NPGA membership status. Companies who
exhibited at the 2012 show must submit exhibit space applications by November 30, 2012
to retain priority placement at the 2013 show. Selections are not guaranteed until a written
confirmation is issued from NPGA. Should selections not be available, the contact listed
above will be notified and provided with alternative selections. NPGA will begin issuing
booth assignments on December 15, 2012. Please indicate booth preferences in the
boxes below.
DATE
EXHIBIT RATES
2.
3.
4.
TECHNOLOGY
CONTAINER
EQUIPMENT
VEHICLE
OTHER __________________________
SERVICES
Please indicate if your booth display will include filled propane cylinders. Refer to Terms
and Conditions available for review at www.PropaneExpo.com/2013Terms for specific
regulations.
NO
YES
Please indicate any competitors and NPGA will make every attempt to avoid assigning
booth space within close proximity.
_____________________________________________________________________________
_____________________________________________________________________________
PAYMENT SCHEDULE
NON-MEMBER RATES
$8.50 VEHICLE
Exhibit space application must be submitted with a 50% deposit of the total amount due.
The remaining balance is due on or before December 31, 2012. Exhibit space applications
received after December 31, 2012 must be accompanied with full payment. Exhibit space
applications submitted without payment will not be processed. If payment is submitted by
check, please submit the check with the exhibit space application. All payments must be
made in U.S. dollars. Payment by wire transfer must include bank fees. No refunds will
be issued for cancellations received after January 31, 2013.
$16.75 VEHICLE
BOOTH PRICE
BOOTH SIZE: _________________________
PAYMENT METHOD
Please select payment amount: (full payment required after December 31, 2012)
50% DEPOSIT: $_________________
FULL PAYMENT: $ ________________
CHECK (made payable to National Propane Gas Association) CHECK NUMBER: _______________
CREDIT CARD:
AMERICAN EXPRESS
MASTERCARD
VISA
_____________________________________________________________________________
CREDIT CARD NUMBER
EXPIRATION DATE
_____________________________________________________________________________
CREDIT CARD HOLDER
_____________________________________________________________________________
AUTHORIZED SIGNATURE DATE
(Signature authorizes National Propane Gas Association to charge the credit card for the amount due.)