Ocotber 30, 2014 Vendor Table Form

The Long Island Alarm Association
P.O. BOX 660, Deer Park, NY 11729
631 424-0119 phone

General Meeting - "Annual Round Table"
Thursday, February 26th, 2015
Vendor Exhibits/Dinner 6:30-10:00 pm
Set up 5:30pm

UPSKY Long Island Hotel 
(Formerly Sheraton LI)
110 Motor Parkway Hauppauge, NY 11788

Please let me know if you can donate any item(s) to be raffled off.
They can be mailed to the above address or call the above # for arrangements to be picked up.

Cost:  $250.00   Non-member price
           $200.00   Member price
Vendor/Manufacturer Name:_____________________________

ATTENDEE Name:_______________________________

Contact telephone #:_________________________

Payment Type:   ____check  ____Credit card
(Please check one)
____ Mastercard   ____Visa          ____American Express

Card #:  __________________________  Zip code____________ 
                                                                    (affiliated with card)
Exp ___ ___ / ___ ___   Code: ___ ___ ___ ___ 

Do you require Electric at your table?
YES______      NO_______