Stall Holder Application Form

* Required

First Name *

Last Name *

Company *

Work Address *

City *

State *

Zipcode/Postcode *

Country *

Work Phone Number *	Cell Phone Number *
Work Fax Number *	Email Address *

Type of Product to be displayed/tasted/sold: *

Power & Connection *
Yes
No

Tent (Includes 1 x Table & 2 x Chairs) *
Yes
No

Extra Tables *
Yes
No

Power *
Yes
No

Voltage

Depth

Width

Wattage/ampage of each appliance