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Booth Request Form <br />Fill out this form if you wish to reserve a Deal Making Booth <br />When <br />Thursday, October 28, 2010 <br />9:00 am — 5:00 pm <br />Friday, October 29, 2010 <br />9:00 am — 12:00 noon <br />Where <br />Hyatt Regency Chicago <br />Booth Fee <br />Check or credit card accepted as payment. Make check payable to ICSC. <br />Booth fee is nonrefundable/nontransferable. <br />Check One: Member Non -Member <br />How to Register <br />Fax: +1 732 694 1806 (Credit card registrations only) <br />E-mail: Peter Bordes, pbordes@icsc.org <br />Mail: ICSC <br />P.O. Box 26958 <br />New York, NY 10087-6958 <br />Booth Contact <br />Company <br />Address <br />10'x10' (100 sq. ft) = $375 (member) / $545 (non-member) <br />10'x20' (200 sq. ft) = $750 (member) / $1,090 (non-member) City State/Province Zip/Postal Code <br />Submission of this application does not imply guaranteed booth space. Exhibit Space is <br />confirmed ONLY in writing. Voluntary cancellations are nonrefundable/nontransferable. Telephone Fax <br />Includes: <br />• Tenant sign <br />• Pipe and drape booth, (pipe and drape will not be supplied with a 20' x 20' Island) <br />• Carpet <br />• One (1) host/hostess badge per exhibitor (to be issued to an administrative/executive <br />assistant ONLY) <br />• Does not include furniture. All furniture required must be ordered from the official contractor. <br />Once space is confirmed, an exhibitor's kit outlining the services will be available. <br />osC <br />ICSC <br />E-mail (2010CDM) <br />Method of Payment <br />❑ Check or money order made payable to ICSC enclosed for $ <br />❑ MasterCard ❑ Visa ❑ AMEX ❑ Discover Total $ <br />Deadline to submit a booth request form to be included in the At -Door Directory is <br />Friday, September 10, 2010. Name (as it appears on credit card) <br />Signature <br />Credit Card Number (include all digits) Expiration Date (month/year) <br />ICSC 2010 <br />CHICAGO! <br />Check all that apply <br />Retailer _ Broker _ Owner/Developer <br />Lenders _ Products/Services _ Municipality <br />