Exhibitor:
 Contact      
Phone#:
Address:
 Contact      
email:
City:
 Contact:  
State:
 Zip:
3.
 Check here if first time attendee
Name
 Title:
email:
 Phone:
4.
 Check here if first time attendee
Name:
 Title:
email:
Phone:
5.
 Check here if first time attendee
Name:
 Title:
email:
 Phone:
6.
 Check here if first time attendee
Name:
 Title:
email:
 Phone:
If new attendee, provide name of person referring you to conference
Total # exhibitor registering
 Total Amount Due:
Check here to indicate you will be mailing your check for payment
My/Our Registration form indicates we have read the Liability, Waiver and Release
Information and the Cancellation and Change Policy and agree to the terms stated.  
Photo Release
I/We hereby give the Utility Payment Conference and its delegated representatives the
permission to photograph me alone and/or with other attendees in conjunction with and
for the conference.  I/We understand the pictures may be used for the promotion of the
conference.  Publications of photographs shall include, but is not limited to, the
conference website, future conferences, promotional brochures and flyers and other
forms of media.
Hotel Reservation Release
I/We hereby give the Utility Payment Conference and its delegated representatives
permission to inquire of the hotel information regarding my booked reservation.  In
addition, the conference hotel(s) has my/our permission to disclose my/our reservation
information to the conference's delegated representation.
1.  Mail U.S. funds check payment.  Fill out form below and submit it electronically.  
2. Online - Click on Credit Payment link on Home Page.  Fill out  form below and submit it
electronically.  
List the information for each person registering for the conference.  
Cost per person:  $425 due by April 1;   $525 due by June 15, $625 due after June 15
ONLY complete this form if you need to register additional representatives to attend. Your first two
representatives (booth staff) are complimentary with your Exhibitor Registration.  
Payment and Registration

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Utility    
Communications, Cooperatives,
Municipalities and Utilities