Exhibitor Application

21st Annual Wisconsin Council on
Problem Gambling Conference
August 11-12, 2020 
Hyatt Regency in Green Bay, WI

EXHIBIT SPACE APPLICATION AND CONTRACT

NAME OF ORGANIZATION:__________________________________________________________________________________

 

ADDRESS:_______________________________________________________________________________________

 

CITY:________________________________________ STATE:______________ZIP________________

 

PERSON(S) RESPONSIBLE FOR EXHIBIT:_________________________________________________

 

ADDRESS, IF DIFFERENT FROM ABOVE:__________________________________________________

 

CITY:_______________________________________ STATE: ___________ ZIP: ___________________

 

TELEPHONE: (____)____________________________ FAX: (____)_____________________________

 

E-MAIL:___________________________________­___________________________________________

 

EXHIBIT SPACE: The cost per table is $175.00. This includes one 8' table and registration for one person to accompany your booth and participate in conference workshops and meals during the conference. Pre-conference workshops are an additional cost, listed below (lunch is not included). Additional persons can attend by completing the registration form found on the conference brochure and paying the applicable conference rate. If the additional person(s) would like meals only it would be an additional $50.00. Space is limited; only 15 exhibitor spaces are available. You will be able to set up any time after 6:00pm on Monday, August 10th. Join or renew your WCPG membership and save $35.00 off the Full Conference Registration (Discount for Memberships of $75 or more).

Do you plan to attend Pre-Conference (August 10, 2020, 8am-3:00pm) workshops?

$ 50.00      "Gambling as a Reaction to Grief" - Dan Smith

$ 50.00      "Leadership 2.0: A Workshop for Supervisors in Behavioral Health" - Mark Sanders

Please check if you plan to attend the following: (included in Exhibit fee)

□ Conference Kick-Off Keynote on Monday, August 10, 2020, 3:30pm-5pm)

ETHICS: □   (you MUST check the box to participate in the Ethics workshop)

AWARDS BANQUET: Tuesday, August 11, 2020, 6:00pm-9:00pm.I will be attending          □ I will not be attending

MEALS: □ Regular      □ Vegetarian

Additional Exhibitor, not attending the conference

$ 50.00    Name:__________________________________________Title:_____________________

MEALS: □ Regular      □ Vegetarian

Attending Awards Banquet   □ Yes      □ No

Electricity needed?  No_______ Yes_______                                   Number of Tables: ______________

Payment enclosed: ___________.  Make checks payable to the Wisconsin Council on Problem Gambling (WCPG).  Payment must accompany application.

□ Yes, I need EAP - Continuing Education

The Wisconsin Council on Problem Gambling, Inc. assumes no liability for damage to exhibits, either in transit to or from the hotel or while the exhibit is in the hotel. The exhibitor assumes all liability for the exhibit.

The Council reserves the right to determine the eligibility of all exhibit space and individual products and services to be exhibited. Exhibits which are determined to be inconsistent with the high standards of the Conference or are otherwise noisy, in bad taste, or conflict with the orderly management of the Conference, will be denied admission to the Conference.

_____________________________________________________________________________________

Signature of Applicant Date

_______________________________________________________________________________________________________

Title/Position

ALL EXHIBIT APPLICATIONS MUST BE RECEIVED BY July 17, 2020

Mail application and payment to:

Wisconsin Council on Problem Gambling, Inc.
Attn: Conference Coordinator
1585 Allouez Ave.
Green Bay, WI  54311