California State University, Northridge Center on Disabilities Technology and Persons with Disabilities 21st Annual International Conference

March 20-25, 2006 Exhibition Dates: March 22-25, 2006
Hilton Los Angeles Airport & Los Angeles Airport Marriott Hotels

The following information will be used for the program and web

Company Name: _________________________________________

Please provide street address for priority mailings (Federal Express, UPS, etc.)
Address: ________________________________________________

City: ___________________________________________________

State/Province: ___________________________________________

Zip/Postal Code: ___________________ Country: _______________

Telephone: (______) ____________________

Fax: (______) _________________________

Company Email: _________________________________________

Website: ________________________________________________

The following information will be used as billing and Exhibit contact information

Company Name: ________________________________________________________________________

Please provide street address for priority mailings (Federal Express, UPS, etc.)
Address: _____________________________________________________________________________

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

In all cases, 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

_____ I would like to the following exhibit booth(s). Otherwise, I will keep my 2005 exhibit booth(s). 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
Northridge, CA 91330-8340
Phone: 818/ 677-2578 V/TTY Fax: 818/ 677-4929
Email: ctrdis@csun.edu Website: www.csun.edu/cod/