2006 REBOOKING APPLICATION CSUN’s 21st Annual International Conference “Technology and Persons with Disabilities” March 20-25, 2006 Exhibition Dates: March 22-25, 2006 Hilton Los Angeles Airport & Los Angeles Airport Marriott Hotels Company Name: ____________________________________________________________ Address: _________________________________________________________________ *provide street address for priority mailings(Federal Express, UPS, etc.) City: ___________________________________________ State/Province: _________________________________ Zip/Postal Code: ________________________________ Country: ________________________________________ Telephone: (______) _____________________________ Fax: (______) ___________________________________ Company Email: __________________________________ Website: ________________________________________ EXHIBIT CONTACT (Responsible for fees, services, and set up of exhibit space) Name: _________________________________________ Email:___________________________________________ EXHIBIT SPACE: Per 8’ x 10’ Exhibit Space (“Booth”) Early Discount: $1,695.00 paid in full by June 30, 2005 20% deposit ($339.00) is required to hold a single exhibit booth Regular Price: $1,895.00 after June 30, 2005 20% deposit ($379.00) is required to hold a single exhibit booth Per 16’ x 20’ Exhibit Space, Island Configuration (“Island”) Early Discount: $7,395.00 paid in full by June 30, 2005 20% deposit ($1,479.00) is required to hold an island Regular Price: $8,195.00 after June 30, 2005 20% deposit ($1,639.00) is required to hold an island Final payment for exhibit booth(s) must be received or postmarked on or before October 21,2005. No deposits will be accepted after October 21, 2005.Full payment is required to secure exhibit space. EXHIBIT BOOTH PREFERENCE: CHECK ONE _____ Keep my 2005 exhibit booth(s): ________________________ _____ Move to the following exhibit booth(s) if they become available. 1. __________ 2. ___________ 3. _________ 4. __________ _____ Other _______________________________________________________ PRODUCT DESCRIPTION A brief description of the company’s products and/or services is required for the 2006 Conference Program (50 words or less): _____ Please use the same Product Description as listed in the 2005 Conference Program PRODUCT CATEGORY: (Please choose ONE): _____Agencies/ Services _____Educational Software _____Alternative Input/Keyboard Devices _____Environmental Control Units (Electronic Aids to Daily Living) _____Augmentative & Alternative Communication (AAC) _____Learning Disabilities _____Assistive Mobility Devices _____Telecommunication Devices _____Blind/ Low Vision _____Other: _________________________________________ ADVERTISING: In the 2006 Conference Program ______ Full Page (7 ½” w x 9” h):$575 ______ Half Page (7 ½” w x 4 ½” h):$365 ______Quarter Page (3 ½” w x 4 ½” h):$195 Note: Artwork due by January 6, 2006 LITERATURE DISTRIBUTION $550 per order of 2,500 pieces Note: Literature due by February 17, 2006 (International, due by January 27, 2006) 2006 CALL FOR PAPERS Please send information on making a presentation at the CSUN 2006 conference. METHOD OF PAYMENT: Check enclosed for $ ________________ (Make payable in U.S. Dollars to: CSUN) Charge to: ____MASTERCARD _____VISA _____ AMERICAN EXPRESS Card # _____________________________________Expiration Date___________ Card Holder Name (print): _________________________________ Signature Please reserve exhibit space for CSUN’s March 20-25, 2006 conference (Exhibition Days: March 22-25, 2006). I / We agree to abide by all rules and regulations. I / We understand that after June 30, 2005, and through January 30, 2006, there will be a $100 cancellation fee. I / We understand that after January 30, 2006, there will be no refunds on any cancellations. Authorized Signature: _____________________________________________ Date: 2006 REBOOKING BEGINS WEDNESDAY, MARCH 16, 2005 Bring your application and 20% deposit to the Speaker/Exhibitor Registration Counter at the Hilton or Marriott REBOOKING APPLICATIONS ACCEPTED VIA MAIL OR FAX BEGINNING WEDNESDAY, MARCH 16, 2005 Please submit application to: Exhibits Coordinator Center on Disabilities ~ CSUN 18111 Nordhoff Street, Building 11, Suite 103 Northridge, CA 91330-8340 Phone: 818/ 677-2578 V/TTY Fax: 818/ 677-4929 Email: ctrdis@csun.edu Website: www.csun.edu/cod