Attending Conference
2012 NAPSEC Annual Leadership Conference
EXHIBIT ORDER FORM
INSTALLATION SITE
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Hook-Up |
Disconnect |
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Date: |
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CONTACT INFORMATION
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Company Name |
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Contact Name |
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Address, City, State, Zip |
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Phone |
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Signature/Date |
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Fax Number |
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Email Address |
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Receipt Method (circle one) |
Fax |
Email (for email please write in a 6 digit code to access web site) ___ ___ ___ ___ ___ ___ |
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PAYMENT INFORMATION
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Guest Room Number/Name |
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OR |
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Credit Card Name / Number / Exp Date: |
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Authorized Signature |
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EQUIPMENT INFORMATION
Phones |
Internet Access |
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Outside Phone Line ($85.00) one time fee |
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Dial-Up Phone Line ($200.00) one time fee |
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D.I.D. / Fax ($200.00) one time fee |
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High Speed Internet Access ($200.00) per day |
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Fax Line ($85.00) one time fee |
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Wireless High Speed Internet Access ($200.00) per day |
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Computers |
Monitors |
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Desk Top ($175.00) per day |
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19” CRT Computer Monitor ($75.00) per day |
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Laptop ($225.00) per day |
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19” LCD Flat Panel Computer Monitor ($125.00) per day |
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Laptop with Wireless Card ($250.00) per day |
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32” LCD Monitor ($250.00) per day |
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Please call if you need dedicated bandwidth for video conference needs |
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42” Plasma w/ stand ($625) per day |
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VHS VCR ($65) per day |
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DVD Player ($95) per day |
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Please call for any additional equipment needs that are not listed above.
Please place the requested number of items in the appropriate boxes for required equipment
24% service charge will be added to orders, plus tax
This order form must be received (10) working days prior to the install date.
This form can be faxed to 866-309-9685 or emailed to chris.diorio@marriott.com
Marriott’s Camelback Inn
5402 East Lincoln Drive, Scottsdale, AZ 85253
480.596.7057 (voice) 866-309-9685 (fax)
If Payment information is not complete or legible your order will not be processed.