Exhibit, or Sponsor - NBNA Conference

2023 NBNA ANNUAL CONFERENCE EXHIBIT BOOTH BADGE REQUEST FORM

Thursday, August 3 - Saturday, August 5, 2023
NBNA 50 Years and Beyond: Leading the Way in Innovation, Built Environments, Advocacy, Mentorship, and Community Engagement
There will be a charge of $25 per person for more than four (4) booth personnel per $1,500 booth. Please provide the names of the individuals who will staff your booth.

Use this Registration & Contract form to pay for additional booth staff.

PLEASE DO NOT SEND THIS FORM UNTIL YOU HAVE CONFIRMED THE NAMES OF THE PERSONS WHO WILL BE WORKING IN YOUR BOOTH.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Company/ Organization Name
1. Booth Staff
Name:
Nursing Credentials if applicable
Company:
E-mail:
Address

Street Address

Street Address Line 2

CityState

Zip Code
2. Booth Staff
Name:
Nursing Credentials if applicable
Company:
E-mail:
Address

Street Address

Street Address Line 2

CityState

Zip Code
3. Booth Staff
Name:
Nursing Credentials if applicable
Company:
E-mail:
Address

Street Address

Street Address Line 2

CityState

Zip Code
4. Booth Staff
Name:
Nursing Credentials if applicable
Company:
E-mail:
Address

Street Address

Street Address Line 2

CityState

Zip Code
Add-on
Additional Booth Staff (Name, nursing credentials if applicable)
Total Enclosed
Credit Card Information

Billing Name

Billing Address

Credit Card NumberExpiration date

Security Code
Signature as it appears on card:
Don't delay, book your hotel reservation today!

HILTON ATLANTA Reservations Link:
https://book.passkey.com/go/NTLBlackNurses2023
Should be Empty:

2023 NBNA ANNUAL CONFERENCE EXHIBIT BOOTH BADGE REQUEST FORM

1. Booth Staff

2. Booth Staff

3. Booth Staff

4. Booth Staff