6th ANNUAL KGA SHOWCASE REGISTRATION FORM

OCTOBER 24-25, 2023

Thank you for your interest in the Kentucky Gas Association.

To register for the 6th Annual KGA Showcase, fill out your company information and add employees or other individuals who are attending the event.

When you have completed the form, review it to make sure the amount and all information is correct. Click the “Submit Registration” button to be directed to PayPal, our preferred payment option.

6th Annual Showcase

COMPANY DETAILS
Company Name*
Company Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Company Phone Number*
Company Email Address*
INDIVIDUAL REGISTRATION
KGA Member Individual - $175
($200 after 10/17)
Number of KGA Member Individuals
Member #1 Name*
Position/Title*
Phone*
Email*
Member #2 Name*
Position/Title*
Phone*
Email*
Member #3 Name*
Position/Title*
Phone*
Email*
Member #4 Name*
Position/Title*
Phone*
Email*
Member #5 Name*
Position/Title*
Phone*
Email*
Member #6 Name*
Position/Title*
Phone*
Email*
Member #7 Name*
Position/Title*
Phone*
Email*
Member #8 Name*
Position/Title*
Phone*
Email*
Member #9 Name*
Position/Title*
Phone*
Email*
Member #10 Name*
Position/Title*
Phone*
Email*
Hidden
Non-Member Individual - $275
($300 after 10/17)
Number of Non-Member Individuals
Non-Member #1 Name*
Position/Title*
Phone*
Email*
Non-Member #2 Name*
Position/Title*
Phone*
Email*
Non-Member #3 Name*
Position/Title*
Phone*
Email*
Non-Member #4 Name*
Position/Title*
Phone*
Email*
Non-Member #5 Name*
Position/Title*
Phone*
Email*
Non-Member #6 Name*
Position/Title*
Phone*
Email*
Non-Member #7 Name*
Position/Title*
Phone*
Email*
Non-Member #8 Name*
Position/Title*
Phone*
Email*
Non-Member #9 Name*
Position/Title*
Phone*
Email*
Non-Member #10 Name*
Position/Title*
Phone*
Email*
DISPLAYING VENDOR REGISTRATION
(6' Tabletop Display)
KGA Member Displaying Vendor - $350
(Includes Registration for One Individual)
($375 after 10/17)
Number of Member Displaying Vendors
Member Displaying Vendor #1*
Position/Title*
Phone*
Email*
Member Displaying Vendor #2*
Position/Title*
Phone*
Email*
Member Displaying Vendor #3*
Position/Title*
Phone*
Email*
Member Displaying Vendor #4*
Position/Title*
Phone*
Email*
Member Displaying Vendor #5*
Position/Title*
Phone*
Email*
Member Displaying Vendor #6*
Position/Title*
Phone*
Email*
Member Displaying Vendor #7*
Position/Title*
Phone*
Email*
Member Displaying Vendor #8*
Position/Title*
Phone*
Email*
Member Displaying Vendor #9*
Position/Title*
Phone*
Email*
Member Displaying Vendor #10*
Position/Title*
Phone*
Email*
Hidden
Non-Member Displaying Vendor - $525
(Includes Registration for One Individual)
($550 after 10/17)
Number of Non-Member Displaying Vendors
Non-Member Displaying Vendor #1*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #2*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #3*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #4*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #5*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #6*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #7*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #8*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #9*
Position/Title*
Phone*
Email*
Non-Member Displaying Vendor #10*
Position/Title*
Phone*
Email*
VENDOR REP INDIVIDUAL REGISTRATION
KGA Member Vendor Rep - $175
($200 after 10/17)
Number of Member Vendor Reps
Member Vendor Rep #1*
Position/Title*
Phone*
Email*
Member Vendor Rep #2*
Position/Title*
Phone*
Email*
Member Vendor Rep #3*
Position/Title*
Phone*
Email*
Member Vendor Rep #4*
Position/Title*
Phone*
Email*
Member Vendor Rep #5*
Position/Title*
Phone*
Email*
Member Vendor Rep #6*
Position/Title*
Phone*
Email*
Member Vendor Rep #7*
Position/Title*
Phone*
Email*
Member Vendor Rep #8*
Position/Title*
Phone*
Email*
Member Vendor Rep #9*
Position/Title*
Phone*
Email*
Member Vendor Rep #10*
Position/Title*
Phone*
Email*
Hidden
Non-Member Vendor Rep - $275
($300 after 10/17)
Number of Non-Member Vendor Reps
Non-Member Vendor #1*
Position/Title*
Phone*
Email*
Non-Member Vendor #2*
Position/Title*
Phone*
Email*
Non-Member Vendor #3*
Position/Title*
Phone*
Email*
Non-Member Vendor #4*
Position/Title*
Phone*
Email*
Non-Member Vendor #5*
Position/Title*
Phone*
Email*
Non-Member Vendor #6*
Position/Title*
Phone*
Email*
Non-Member Vendor #7*
Position/Title*
Phone*
Email*
Non-Member Vendor #8*
Position/Title*
Phone*
Email*
Non-Member Vendor #9*
Position/Title*
Phone*
Email*
Hidden
SPONSORSHIP
Choose a Sponsorship Level
- No Thank You
- Diamond Sponsorship - $2,500
- Platinum Sponsorship - $1,500
- Gold Sponsorship - $1,000
- Silver Sponsorship - $500
- Bronze Sponsorship - $250
Upload Sponsorship Logo
Accepted file types: png, Max. file size: 2 MB.
Please Submit a High Resolution PNG Logo File
PROGRAM ADVERTISING
Program Advertising
- No Thank You
- 5x7 Program Advertisement - $100
Upload Program Ad
Accepted file types: jpg, Max. file size: 2 MB.
Please Submit a High Resolution JPG Ad File
Event Total
$0.00
Email
This field is for validation purposes and should be left unchanged.