February 25, 2016 vendor table form

            
            Long Island Alarm Association
P.O. BOX 660, Deer Park, NY 11729
          631 424-0119 phone
       www.lialarm.org
   Annual Round Table
Thursday, February 25th, 2016
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 us 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:                    $225.00 Member price (may be applied to a membership package if paid prior to
                                                       package selection, refer to Associate Membership Application)

                                                       $275.00 non 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_______