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2016 EXHIBIT SPACE APPLICATION/CONTRACT
March 22-24, 2016 - Indiana Convention Center - Indianapolis, IN
Please complete and return to Judi DuPont, M-PACT Exhibitor Coordinator:
112 W. Cook Street, Springfield, IL 62704. Or e-mail to [email protected].
Company/Contact Information
First Time Exhibitor
Previous Exhibitor. Company Name:__________________________
1. Mailing Address:
This information will be used to mail exhibitor materials and for our on-site guide directory.
2. Contact Information:
This information will be used to mail exhibitor materials and for our on-site guide directory.
Company_________________________________________________________
Official Contact_______________________Job Title__________________________
Address__________________________________________________________
Telephone (Business)_______________Ext.#_______(Mobile)__________________
City_____________________________________State_______Zip___________
Email Address_________________________________________________________
3. Membership Information: Are you a member of any of the following trade associations? Check all that apply:
IPMA/IACS - Illinois Petroleum Marketers Association/Illinois AssociatIon of Convenience Stores
IPCA - Indiana Petroleum Marketers & Convenience Store Association
KPMA - Kentucky Petroleum Marketers Association
OPMCA - Ohio Petroleum Marketers & Convenience Store Association
IPGA - Indiana Propane Gas Association
ILPGA - Illinois Propane Gas Association
4. Booth Size: Select booth type, dimension and number of requested corners. Booth descriptions and floor plan found online: www.m-pact.org/exhibit.
*Reserve before June 30, 2015
$ 2,350 - 10’ x 10’
$ 2,450 - 10’ x 10’ Corner
$ 2,250 - 10’ x 10’ Additional
$ 5,800 - 20’ x 20’ Island
$10,100 - 20’ x 30’ Island
$11,500 - 20’ x 40’ Island
$15,800 - 20’ x 50’ Island
7. Product/Service Category Listing:
Facility Development and Store Operations
Foodservice Equipment & Programs
Technology
Merchandise, Candy and Snacks
*Trucks
$ 3,300 - 10’ x 30’ or 40’ Tank Wagon
$ 3,800 - 10’ x 45’ or 50’ Transporter
$ 1,800 - 10’ Additional Space
*NOTE: Booth rates will increase on July 1, 2015.
Book early to lock-in reduced rates.
5. Booth Location Preferences:
The following will be used as a guide in assigning your exhibit space.
a. Assignment Preference:
Which booth(s) or trucks(s) do you prefer to reserve?
Please list in order of priority:
1.)_______________ 2.)_______________ 3.)________________
b. Partner Proximity: We would like to be near________________________________
c. Competitor Proximity:
We prefer not want to be near____________________________
Fuel Equipment & Services
8. Payment:
1. Booth Price
$________________
2. Optional Premium Booth Package $________________
Total Due
$________________
50% Deposit $________________
Balance Due $________________ Due by February 1, 2016
VI
MC
AX
Make checks payable to M-PACT.
Check
Cardholder:__________________________________________
Card Number:________________________________________
Expiration Date: ______________________________________
Security Code:________________________________________
Signature:____________________________________________
6. Premium Booth Package Upgrade
Yes, I would like to enhance my exhibition exposure ($100)
Logo placement with expanded company listing (Additional 25 words) in
the online exhibitor directory, mobile app, and on-site guide.
Send Payment and Application to:
M-PACT Exhibitor Coordinator Judi DuPont
112 West Cook Street, Springfield, IL 62704
Phone: 217.241.0507
E-mail: [email protected]
9. Terms & Conditions Agreement Acknowledgement
Exhibitor agrees to abide by the 2016 Terms and Conditions and the 2016 Rules and
Regulations which are fully incorporated herein. The undersigned is empowered to enter into contracts on behalf of the exhibiting company.
X__________________________________________________
Signature
___________________________________________________
Date
DATE RECEIVED__________ DATE ASSIGNED__________ SPACE ASSIGNED___________