Research Appreciation Day - Vendor Registration

Vendor Online Registration Form

Registration Deadline: March 16, 2012

Please provide the following information. Upon receipt of your registration, you will receive a confirmation by e-mail or fax.

The registration fee is $250 and includes a listing in the abstract book and one six-foot table with white tablecloth. Checks must be made payable to the UNT Health Science Center RAD Foundation and mailed to:

UNT Health Science Center at Fort Worth
Attention: Susan Harlin
Office of Strategic & Translational Research Initiatives
3500 Camp Bowie Boulevard
Fort Worth, Texas 76107

Table assignments will be made as registration fees are received. Electrical access is limited.

* indicates required fields

*Company:

Product Type/Division:

*Mailing Address:

*City: *State: *ZIP:

*Telephone:

*FAX:

*E-mail address:

*Number of representatives:

*Representative(s) Name(s):

Electrical outlet requested (check for yes):

Homepage URL: http://

Please double check all information before clicking the register button, using the back button and clicking "Register" again will create multiple entries for you.

Please direct questions about vendors to Susan Harlin.
Phone: (817) 735-2742 Fax: (817) 735-0375.