WORK Authorization Form

Deadline: Oct. 14, 2011

	*indicates required field
Work Authorization Request (pdf)
Independent Service Company #1
Company Name:	*
Contact Name:	*
Address 1:	*
Address 2:	*
City:	*
State:	*
Zip Code:	*
Phone:	*
Independent Service Company #2
Company Name:
Contact Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:

Are these service companies authorized to order show services for your company?
	Yes
	No

Exhibiting Company:	*
Booth:	*
Requested by:	*
E-mail:	*
Phone:	*
Date:	*

Please retain a copy of this form for your files.

This form must be received at SCTE Headquarters by October 14, 2011.