REGISTRATION

Celebrate Science Indiana 2019 will be held on Saturday, October 5th from 9:30 AM to 5:00 PM in the Elements Financial Blue Ribbon Pavilion at the Indiana State Fairgrounds.

To become a sponsor/exhibitor at Celebrate Science Indiana 2019, please register using the form below. Upon receiving your registration information, we will send you an invoice for the amount of your sponsorship level.

If you are a Not-For-Profit organization and require financial assistance to be an Exhibitor at Celebrate Science Indiana, please contact us.

The Event Decorator will handle all requests for extra tables, chairs, electricity and internet. You will receive a packet from the Event Decorator to order these accessories.

YOU MUST CLICK THE SUBMIT BUTTON AT THE BOTTOM OF THE FORM TO COMPLETE YOUR REGISTRATION. IF AFTER SUBMITTING YOUR REGISTRATION YOU DO NOT SEE A NEW WEB PAGE WITH THE MESSAGE: "Thanks for registering! We will be in touch with you shortly.", PLEASE CONTACT ROBERT YOST.

* Required entry

Contact Information

Name of person registering*

Name of person registering *

First Last

Organization*

Organization *

Address*

Address *

Street Address Address Line 2 City State ZIP Code

Phone number (mobile)*

Phone number (mobile) *

Email address*

Email address *

Name of person responsible for booth setup*

Name of person responsible for booth setup *

First Last

Email address of person responsible for booth setup*

Email address of person responsible for booth setup *

Name of point-of-contact person the day of the event*

Name of point-of-contact person the day of the event *

First Last

Email address for point-of-contact the day of the event*

Email address for point-of-contact the day of the event *

Choose your level:*

Choose your level: *

Sponsor
Exhibitor

Select Exhibitor Booth Size*

Select Exhibitor Booth Size *

10'x10' $250
10'x20' $400
20'x20' $750

Select Sponsorship Level*

Select Sponsorship Level *

Select Payment Method

Please indicate your preferred method of payment and we will send you an invoice. DO NOT enter credit card information on this form.*

Please indicate your preferred method of payment and we will send you an invoice. DO NOT enter credit card information on this form. *

Send us an invoice to pay by PayPal (Visa/MC/Discover)
Send us an invoice to pay by check
Other - please specify below

Special Requests

Special Requests

YOU MUST CLICK THE SUBMIT BUTTON BELOW TO COMPLETE YOUR REGISTRATION. IF AFTER SUBMITTING YOUR REGISTRATION YOU DO NOT SEE A NEW WEB PAGE WITH THE MESSAGE: "Thanks for registering! We will be in touch with you shortly.", PLEASE CONTACT ROBERT YOST.

Name

This field is for validation purposes and should be left unchanged.

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