Media Summit New York Exhibitor/Sponsor Contract - Page 2 March 7-8, 2012, McGraw-Hill Building, 49th St. and 6th Ave., New York City Print Out and Return This Form It is understood that I have read the terms of this Contract as they appear on Page One. Agreement dated_____________________Between Media Summit New York and Company_________________________________________________________________ Your Name ______________________________Title_____________________________ Address__________________________________________________________________ City_______________________________State_________________Zip_______________ Telephone_______________________________Fax_______________________________ email_____________________________________________________________________ Your Signature_____________________________________________________________ Booth Choice or Sponsorship Choice _________________(as assigned by via phone) 1st Choice _________________ 2nd Choice_______________ 3rd Choice ______________ (We will make every effort to satisfy one of your three choices, although it can not be guaranteed) Booth or Sponsorship Fee $___________________ Payment Via by Credit Card - Circle one: American Express - Visa - Master Card Amount to be Charged Credit Card - $_____________ Cardholder Name___________________________________________________________ Card Number______________________________________Expiration Date____________ Signature__________________________________________________________________ Payment by Check Please Make Check Payable and Return To: Digital Hollywood, 100 11th Ave., #4B, New York, NY 10011 or fax: 212-206-0476 For Help call: 212-352-9720. Payment in U.S. Currency. If check is drawn on a non-US bank, add $55 for collection. Approved and Accepted by DH____________ A Signed and Approved Copy of this Form will be returned to you.