Crossroads Venture Fair
Reservation Form
April 29 - 30, 2008
Stamford Marriott - Stamford, CT
Name: |
___________________________________________________________ |
Company: |
___________________________________________________________ |
Address: |
___________________________________________________________ |
Phone: |
___________________________________________________________ |
| 1. Attendees Name | ___________________________________________________________ |
| Company Name (if different) | ___________________________________________________________ |
| Phone Number (if different) | ___________________________________________________________ |
| Please circle one | (Tue Only) (Wed Only) (Both Days) |
| 2. Attendees Name | ___________________________________________________________ |
| Company Name (if different) | ___________________________________________________________ |
| Phone Number (if different) | ___________________________________________________________ |
| Please circle one | (Tue Only) (Wed Only) (Both Days) |
| 3. Attendees Name | ___________________________________________________________ |
| Company Name (if different) | ___________________________________________________________ |
| Phone Number (if different) | ___________________________________________________________ |
| Please circle one | (Tue Only) (Wed Only) (Both Days) |
| 4. Attendees Name | ___________________________________________________________ |
| Company Name (if different) | ___________________________________________________________ |
| Phone Number (if different) | ___________________________________________________________ |
| Please circle one | (Tue Only) (Wed Only) (Both Days) |
| Fees | |
| Equity Investors | Non-Member: $290 / CVG Member: $190 / Door: $390 |
| All Others | Non-Member: $490 / CVG Member: $390 / Door: $590 |
| Payment Method: | |
| [ ] Charge Credit Card #_________________________________________ EXP: ___/____ [ ] Check enclosed [ ] Send Invoice |
|
| Submitted By: ___________________________________ Contact Number: __________________________ |
Please fax this form to 203-256-9949 by April 15th. You may also call information in to 203-256-5955.