Exhibitor Booking Form

To apply for a site at the 2012 Surat Basin Energy and Mining Expo, simply complete the below form. One of our sales staff will be in contact shortly after with site options, pricing schedules and site maps.

Company:
Contact Name:
Position:
Phone:
Fax:
Email:
Mobile:
Postal Address
Suburb:
State:		QLD NSW VIC ACT SA WA NT
Postcode:
Country:
Products/Services to be displayed:
Prefered Site Size:		Select 3m x 1.8m Indoor Boothed Site 3m x 3m Indoor Boothed Site 6m x 3m Indoor Boothed Site 6m x 6m Indoor Boothed Site OTHER Indoor Boothed Site Outdoor Space under 100m2 Outdoor Space over 100m2 OTHER Site Option
Are you interested in Sponsorship Options		Select Yes No
Other Requirements and notes:
Power Requirements		No Power 4amp Power Other
How did you hear about this event ?		Select Television Newspaper Magazine Radio Internet Billboard Word of Mouth
Please verify you are a real person by copying the verification code