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Contact your Representative
Contact your Senator
2010 MDVA Convention
Registration Form
August 6-8, 2010
Boyne Mt. Resort, Boyne Falls, MI
Company Name
Contact Person
Street Address, City, State, Zip
Telephone
Fax
Email
Please note: Acknowledgement of this registration and all future correspondence will be done to this email address
Classification
Registration Fee *
MDVA Member
Registration Fee *
MDVA Non-Member
Wholesaler (W)
$375
0
1
2
3
4
$400
0
1
2
3
4
Vendor (V)
$375
0
1
2
3
4
$400
0
1
2
3
4
Associate (A)
$375
0
1
2
3
4
$400
0
1
2
3
4
Spouse (S)
$100
0
1
2
3
4
$125
0
1
2
3
4
Young Adult Child (AC)
$100
0
1
2
3
4
5
6
$125
0
1
2
3
4
5
6
Child (under 12) (C)
$75
0
1
2
3
4
5
6
$100
0
1
2
3
4
5
6
* Registration fees include meal tickets for: Friday Lunch and Dinner banquet, Saturday Breakfast, Lunch and Dinner
Registration fees may increase after July 15, 2010
Classification
Last Name:
First:
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Copyright © 2003 Michigan Distributors $ Vendors Association
Last modified: 10/12/08
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