Regional Events Registration Form
Please fill out the following form if you are a retailer and would like to attend:
* = required information

Which Regional Event will you be attending?*
First Name*
Last Name*
Title*
Company Name*
Address
Street Address*
City*
State
Zip Code
Contact Information
Phone
eMail*
Retailer Only. Only retailers are eligible to attend the regional dinners. A non-retailer is anyone who seeks a business-to-business relationship (client, partner, etc.) with retailers. If you have questions about your retailer/non-retailer status, please contact Joann Brown at brownj@shop.org or call 202.626.8164 before you register and/or make travel plans for this event. Shop.org makes every effort to notify non-retailers who register for retailer passes by accident as soon as possible. However, Shop.org reserves the right to cancel anyone who registers as a retailer incorrectly.

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