Vendor RegistrationHealth & Wellness Please enable JavaScript in your browser to complete this form. - Step 1 of 8Name of Business *Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *FaxEmailContact Name *FirstLastNextSponsorship PackagesAll packages include booth space, advertising in the show book, and the specific level perks.Gold Sponsorship Package1 Booth Package - $ 1,150.002 Booth Package - $ 1,450.004 Booth Package - $ 2,000.00None - $ 0.00Silver Sponsorship Package1 Booth Package - $ 750.002 Booth Package - $ 1,050.00None - $ 0.00Bronze Sponsorship Package1 Booth Package - $ 550.002 Booth Package - $ 850.00None - $ 0.00PreviousNextSponsorships & Booth RentalPlease note that booth rental is addition to the booth including in any of the sponsorship packages. Sponsorship OnlyGold - $ 500.00Silver - $ 250.00Bronze - $ 150.00None - $ 0.00Booth Rental1 Booth - $ 325.002 Booths - $ 650.003 Booths - $ 975.00None - $ 0.00Please note that this booth rental is in addition to the booths included in the sponsorship packages. Each Booth is 10' x 10'PreviousNextBooth AmenitiesFree 8' TableFREE ChairsAdditional TablesEach Additional Table - $10.00None - $ 0.001 Table - $ 10.002 Tables - $ 20.003 Tables - $ 30.004 Tables - $ 40.005 Tables - $ 50.006 Tables - $ 60.007 Tables - $ 70.008 Tables - $ 80.009 Tables - $ 90.0010 Tables - $ 100.00Table SkirtsEach Table Skirt - $10.00 (Purchase Only)None - $ 0.001 Skirt - $ 10.002 Skirts - $ 20.003 Skirts - $ 30.004 Skirts - $ 40.005 Skirts - $ 50.006 Skirts - $ 60.007 Skirts - $ 70.008 Skirts - $ 80.009 Skirts - $ 90.0010 Skirts - $ 100.00Skirt ColorSelect Color For Table SkirtsBlackBlueGoldGreenMaroonWhiteSecond Skirt ColorSelect Color For Table SkirtsBlackBlueGoldGreenMaroonWhiteIf you choose a second color, expect to receive half of each.10' x 10' Booth CarpetEach 10' x 10' Carpet - $75.00None - $ 0.001 Booth Carpet - $ 75.002 Booth Carpets - $ 150.003 Booth Carpets - $ 225.004 Booth Carpets - $ 300.005 Booth Carpets - $ 375.006 Booth Carpets - $ 450.007 Booth Carpets - $ 525.008 Booth Carpets - $ 600.009 Booth Carpets - $ 675.0010 Booth Carpets - $ 750.00Electrical Needs110v Electrical Drop110v Electrical Drop - $25None - $ 0.001 - 110v Drop - $ 25.002 - 110v Drops - $ 50.003 - 110v Drops - $ 75.004 - 110v Drops - $ 100.005 - 110v Drops - $ 125.006 - 110v Drops - $ 150.00PreviousNextAdditional Name Tags0 Booth Worker Name Tags - $ 0.006 Booth Worker Name Tags - $ 60.001 Booth Worker Name Tags - $ 10.007 Booth Worker Name Tags - $ 70.002 Booth Worker Name Tags - $ 20.008 Booth Worker Name Tags - $ 80.003 Booth Worker Name Tags - $ 30.009 Booth Worker Name Tags - $ 90.004 Booth Worker Name Tags - $ 40.0010 Booth Worker Name Tags - $ 100.005 Booth Worker Name Tags - $ 50.00Please Note: This chart is for additional name tags. For each booth purchases you will receive two badges free.Name TagFirstLastName TagFirstLastName TagFirstLastName TagFirstLastName TagFirstLastAdditional NamesPreviousNextAdvertising in the Midwest Health Show BookShow Book AdsFull Page Ad (5" x 8") - $ 350.00Half Page Ad (5" x 4") - $ 200.00Quarter Page Ad (5" x 2") - $ 125.00Please Note: All sponsorship packages include a show book ad. (Gold - Full Page, Silver - Half Page, & Bronze Quarter Page)Artwork CreationCreate New Ad - $ 40.00Change Current Ad - $ 40.00Provide Camera Ready Artwork - $ 0.00PreviousNextVendor ReferralBe the first to refer a vendor who purchases a booth and receive $100 cash rebate. No Limit!Company NameContact NameFirstLastContact PhoneHave another referral?YesNoCompany NameContact NameFirstLastContact PhonePreviousNextTotal$ 0.00Updating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.Payment Method *CheckCredit CardMakes checks payable to Midwest Health & Wellness Expo and mail to 2020 N 450 W, LaGrange, IN 46761Please be prepared to make a credit card payment when contacted to confirm order. DO NOT mail or fax credit card information.PreviousSubmit