Consortium for Computing in Small Colleges    The Third Annual Northwestern Conference    VENDOR  REGISTRATION FORM

CCSCNW-2001 October 5-6, 2001 Pacific Lutheran University, Tacoma, WA

Company: _______________________________ Department:__________________________
Address:_____________________________ City:_______________________________ State:______________ Zip ___________	Email:_______________________________ Phone:______________________________
Names of Vendor's Representatives who will be attending :	_________________________________ ___________________________________   __________________________________
Contact person :   Name __________________________         email: __________________________    telephone: _______________________
		Cost	Number	Amount
Vendor's Registration Fee (includes vendor's exhibit table and  conference nametags for 3)		$150.00	___	$________
National Vendor registration (includes registration at all nine regional CCSC conferences, and vendors will be acknowledged in all issues of the journal and on the CCSC web page.)		$2000/yr		$________
Additional vendor's representatives beyond the 3 included in registration)		$ 30.00 ea	___	$________
Conference break sponsorship Guest tickets for Saturday luncheon: Guest tickets for Friday dinner:		$250   $10.00 $25.00	___  ___ ___	$________  $________ $________
Copies of Proceedings: Other:		$10.00 $	___  ___	$________ $ ________
Total Amount Paid				$ _______

Will your vendor's exhibition table require electrical power?    Yes _____     No ______  

Any other considerations - please list: 

Make checks payable to:  Consortium for Computing in Small Colleges

with a notation for CCSCNW 2001

Please remit to:

Dr. Jerry Roth

MSC 2615

Gonzaga University

Spokane, WA 99258-2615