LET’S TALK REAL TALK, INC.

REBUILDING THE FAMILY DREAM

Vendor Form

SEMINAR: THE KEY TO ACHEIVING A SUCCESSFUL

RELATIONSHIP: GETTING THE LOVE YOU WANT

Speaker:           JOHN WAGNER MS,LMHA,NCC

WHEN:          Saturday, JULY 25, 2009

4PM - 7PM

LOCATION:            JE MYERS LIFE CENTER

1021 EMERSON DR.

PALM BAY, FL 32908

SPACE FEE: $25.00 (one table) Fee includes 6’ table and 2 chairs for first table, one chair with each additional table

OTHER OPTIONS:

$50.00 per (one table) 2 minutes presentation on your company’s products/services /website

$100.00 YOUR BUSINESS AD ON ALL OUR PROMOTIONAL LITERATURE AND ON

OUR WEBSITE/ 2 MINUTES PRESENTATION/ TABLE

Business Representative: ____________________________________ Title: ___________

Business Name: __________________________________________

Business Type: ________________

Street Address: ___________________________________________________________

City, State, Zip: ___________________________________________________________

Business telephone number: ______________________ Fax number: ________________ Cell:_______________ E-mail Address: ___________________ Website: ________________

Amt$: ______________ CC Payment Card#: _________________________________________

Exp. Date: __________________ CSV: _______________

How many spaces? _____ Tables required?______ Electric needed? YES ( ) NO ( )

Table assignments will be provided upon arrival on June 6

Set up time is from 9::00 am – 9:30 am

**Space is limited and will be provided on a first come, first serve basis.

Please make checks payable to “Let’s Talk Real Talk”. Check must be sent with application form to reserve your space

Register online: www.letstalkrealtalk.com OR Fax your completed form to us (321) 956-6160

You will receive a vendors badge for the event.