STAPLE! 2019 Exhibitor Application TABLES ARE SOLD OUT! Further entries will be added to the waiting list and be contacted if a spot becomes available. Please read these instructions and fill out the form below to apply for STAPLE! 2019. Read ALL of the APPLICATION INSTRUCTIONS: Fill out and sign form below. Fields marked with an asterix (*) are required. Do NOT use a Yahoo email address - they block the confirmation email. Click submit. After you submit DOWNLOAD & PRINT the PDf of your form on the next page. (You’ll also receive an email with a link to the PDF) MAIL in the printed form with a check or money order made out to Independent Media Ventures for your payment. We cannot accept electronic payment at this time. Your spot is reserved but not secured until payment is received. The mailing address is: Independent Media Ventures 5518-A Woodrow Ave. Austin, TX 78756 Payment must be received within FIFTEEN (15) DAYS of your application. After your payment is received you'll be sent an email confirming your spot at STAPLE! Look for your confirmation email(s). You may have to check your spam folder. NOTE: No refunds for cancellation after 9/1/19. Each table comes with TWO exhibitor badges. For more than two exhibitors you must purchase extra badges at $15 each, and provide the person’s name under the Additional Exhibitors section of the form. If you purchase the extra badge but do not give their name, that person will receive a wristband during check-in at the show. Electricity is not provided at the show. By applying to exhibit at STAPLE! you agree to abide by our Anti-Harassment Policy Name*First & Last - Include preferred pronouns here if desired.CompanyAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone*Email* Do NOT use a Yahoo email address! Their servers will reject your confirmation email!Website TwitterInstagram Enter in information for additional exhibitors (up to 5) below.Additional Exhibitor One: NAMECompanyEmail Website TwitterInstagram Two: NAMECompanyEmail Website TwitterInstagram Three: NAMECompanyEmail Website TwitterInstagram Four: NAMECompanyEmail Website TwitterInstagram Five: NAMECompanyEmail Website TwitterInstagram Indicate below the number of Full (8') or Half (4') Tables you wish to purchase. (Note: A half table is a full sized table that is shared with another exhibitor.)Full Table (8 feet) Price: $190.00 Quantity: Includes 2 badges.Half Table (4 feet) Price: $115.00 Quantity: Includes 2 badges.Extra Badges Price: $15.00 Quantity: For more than two exhibitors.Total $0.00 Signature*HOLD HARMLESS: By agreeing to exhibit at STAPLE! The Independent Media Expo, the exhibitor agrees to protect, keep and save STAPLE!, Independent Media Ventures, and the Millennium Youth Entertainment Complex, forever harmless from any damage, loss, theft, cost, liability or expense that arises from their exhibiting at this show. This agreement covers full setup, run of the show, breakdown and move out. By signing above you are indicating your approval of all information contained. Filling out and submitting this form constitutes consent to use your name, the names of your company and publications, and your website address on the STAPLE! website. Your personal information will not be sold or used for any other purpose.I have read all of the application instructions:* Yes PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle AJAX powered Gravity Forms.