2022 Special Education Leadership Academy: Connecting Through Challenge, Change, and Opportunity Vendor Registration

First Name *

Last Name *

Company / Organization Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Telephone Number (Including Area Code) *

Email Address *

I will be exhibiting the following types of products: *

DEADLINE FOR Registration and Payment are June 30, 2022

The Exhibitor table fee is: $500

Make your check payable to: Intermediate Unit #1

(Sorry, we cannot accept credit cards)

Please return this completed form and check to:

PaTTAN West

3190 William Pitt Way

Pittsburgh, PA 15238

Email: billing@pattanpgh.net