Vendor Registration Form

Vendors interested in securing a table at the 2011 MLBCF Conference should complete the form below or download, sign, fax (816) 861-2845 or mail to: MLBCF, 4609 Paseo Blvd, Kansas City, Mo 64110. Vendors must be a nonprofit. No exceptions.

1. Vendor Registration Information
2. Vendor Hold Harmless Agreement
3. Vendor Registration Form
Online Registration
Please fill in all fields marked with a *
Company Name:
 *
  (Please list name as it will appear on exhibit ID sign, company name only, please)
Contact Person:
 *
Address:
City:
State:
Zip:
Phone:
Fax
E-Mail Address:
Comments:
Extra Chairs:
Electricity:
Phone Lines:
Placement invendor area:
Registration level:
 *
Security Image:
 CAPTCHA Image
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Missouri Legislative Black Caucus Foundation
4609 Paseo, Suite 102  |  Kansas City, MO 64110  |  Toll free 1-877-636-5223  |  Email: mlbcf@aol.com
The Foundation is tax exempt under section 501(C) (3) of the Internal Revenue Code. Contributions and deductible under Section 170 of said code.
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