REGULAR/THEMED AFFILIATE EXHIBIT KIT ORDER FORM

Either print and complete the Regular/Themed Affiliate Exhibit Kit Order Form below or e-mail the information to .   Or if you prefer, mail completed forms to: Division Director of Communications and Affiliate Services, NCTE, 1111 W. Kenyon Road, Urbana, Illinois 61801-1096; or fax 217-278-3760; or call 800-369-6283, ext. 3633 or 217-278-3633 with questions. 

DATE:

COMPLETE NAME OF AFFILIATE:

DATE(S) OF MEETING:

NAME OF PERSON ORDERING KIT:

                                   ADDRESS:

                                  TELEPHONE:

                                  FAX:

                                  E-MAIL:

IF DIFFERENT, NAME OF PERSON TO SHIP KIT TO:

                                  ADDRESS:

                                  TELEPHONE:

                                  FAX:

                                  E-MAIL: