VENDOR REGISTRATION

VENDOR

REGISTRATION

VENDOR INFORMATION

Vendor Attendee First and Last Name*

Preferred Name

If different from above. (This will appear on your name tag.)

Vendor Company Name*

Street Address*

City*

State*

Zip Code*

Vendor Phone Number*

Phone

Vendor Email Address*

Vendor Expo Expectations

All vendors are expected to exhibit during the entire conference.

Please see the vendor expo schedule below.

Monday, October 27, 2025, 3:00-7:00PM, vendor load-in/set up

Tuesday, October 28, 2025, 7:00AM–7:00PM

(Reception in Expo space from 5:00–7:00PM)

Wednesday, October 29, 2025, 7:00AM–6:30PM

(Reception in Expo space from 5:00–6:30PM)

Thursday, October 30, 2025, 7:00AM–NOON

Thursday, October 30, 2025, NOON-1:00PM, expo tear-down

All vendors will receive one 6'x30" tabletop, 2 chairs, and a small wastebasket.

Will You be Providing a Door Prize?*

Select

Will You Need Power?*

Vendors requesting power will be provided with one standard 110 volt outlet per booth.

Select

Vendor Registration Fee*

Includes meals listed below, based on conference date(s) selected.

Exhibit Fee, includes registration for 1 person - $600

If you have additional vendor attendees for you company, please have each one complete an attendee registration.

Vendor Meal Attendance (select all that apply)*

Based on the conference registration option you selected above, please let us know which meals/events you plan to attend during your conference stay.

Please Note Any Dietary Needs Here

VENDOR BILLING INFORMATION

Please complete the section below if the vendor attendee information you entered above is different from your company's billing information.

Please include your company's accounts payable contact information, if applicable.

Is the Vendor Information Entered Above to be Used for Billing?*

An invoice will be emailed to you (or the accounts payable contact listed below, if included) within 3 business days of submitting this registration. Please follow the instructions in that email to complete your payment.

Please submit your payment promptly as registrations are not considered complete until payment has been received.

If you need assistance please reach out to hminnix@va811.com.

Select

Company Name

Vendor's Company Mailing Address

Vendor's Company Phone Number

Phone

Vendor's Company Accounts Payable Contact

Vendor's Company Accounts Payable Phone Number

Phone

Vendor's Company Accounts Payable Email Address

You Are Responsible For Making Your Hotel Reservations.

Once you select the submit button below a new page will open that contains booking links to hotels in the conference room block.

Is Your Company Interested in Being a Conference Sponsor?

If so, please contact Frank Giannini, Virginia 811's Manager of Public Awareness

(fgiannini@va811.com or 540-240-1234) for more information.

Send me a copy of my responses

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