46TH ANNUAL
AG MECH FARM EXPO
FEBRUARY 6TH AND 7TH, 2016
REGISTRATION FORM
Refer to the exhibit map for your exhibit site choice(s) and specify if more than one space is desired.
1st Choice:_________________________
2nd Choice:_________________________
Outside Exhibit Space? (Yes/No):__________. If yes, length (in feet) of space needed__________.
Type of Product or Service:_____________________________________________________________
Estimated weight of machine or
equipment:__________________________________________________
PLEASE ANSWER THE FOLLOWING QUESTIONS:
1. Do you have special needs other than the 120 volt electrical service provided at your booth?
(Yes/No)________. If yes, please explain you specific needs. Some special requests will have an
additional charge.
2. Company Name as you would like it to appear on the Show
Program:_________________________________________________________________________
3. Preferred method of contact: (i.e. phone, email, etc.) _____________________________________
4. Representative Name:_______________________________________________________________
5. Title:_____________________________________________________________________________
6. Address:__________________________________________________________________________
7. City:___________________________________________; State:_______; Zip Code:____________
8. Telephone Number: (_____)________________
Return to:
Email: _________________________________
Agricultural Mechanization Club
School of Agriculture
Western Illinois University
Macomb, IL 61455
(309) 298-1231
www.wiufarmexpo.com
NOTES
December 3, 2015