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fill in AMOUNT
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| Six-foot table with chairs | SALALM members | $250_____________ |
| Non-members | $350_____________ | |
| Half-table (three feet) with chairs | SALALM members | $135_____________ |
| Non-members | $185_____________ | |
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Contribution: Co-sponsorship of Book dealers Reception
(If not already sent to LINDA RUSSO) |
$180_____________ | |
| $Flyers: 300 individual flyers with your companys information will be placed in registration packets | $150_____________ | |
| Internet Telephone line | $25______________ | |
| Optional trip: Thursday, June 1, to the Getty Center | $35______________ | |
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$35______________ | |
| Credit card handling fee | $3_______________ | |
| Receipt will be included in your registration packet. | Total _____________ | |
Form of payment: Check ___________ Credit Card __________
Credit card information (required to process payment by credit card)
Card Number ____________-____________-__________-__________
Visa _____ Mastercard _____
Expiration date __________________
Signature ____________________________________
Exhibitor Requirements:
Electrical outlet? ______ yes _____ no
Telephone line for Internet access? ______ yes
(NOTE: $25 installation fee) ______ no
Shipping materials in advance? ____ yes ______ number of boxes _____no
Mail form and payment to:
Barbara Valk
SALALM XLV
UCLA Latin American Center
10343 Bunche Hall
Los Angeles, CA 90095-1447
USAIf paying by credit card, fax to (310) 206-2634.
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