Exhibition Hall Application/Contract Pinball Expo 2011
 Oct 19 to Oct 23, 2011 Westin Chicago North Shore, 601 N. Milwaukee Ave, Wheeling IL 60090
Please print out this form, complete and mail to PINBALL EXPO Headquarters.
Complete one form for each exhibitor/company.
This form must arrive NO LATER THAN October 1 (after this date there's a $25 surcharge.)

Company:____________________________________________________________________

Name:__________________________________________ Title: _____________________

Address:____________________________________________________________________

City:__________________________________________ State:______________________

Postal Code: ______________ Country:________________________________________

Business Phone:___________________________ Cell: ___________________________

Fax:____________________ Email:_____________________________________________

Web URL Address:____________________________________________________________

Booth Sign (maximum 20 letters per line, 2 lines total):

Product/Service Description:___________________________________________________
Number of Booths WITH Electricity at $275 each:_______ Total:_________
Number of Booths with NO Electricity at $250 each:______ Total:_________
Late Registration after October 1: add $25
Total Booth Space Cost: ______________
Deduct 5% for multiple booths:_________
TOTAL:___________________________
Number of Tables Required:_____________
Number of Chairs Required:_____________
Number of Electrical Outlets Required:_____________
List names below that will appear on your exhibit badges.
One booth=2 badges, two booths=3 badges, three booths=4 badges, four booths=5 badges.
 1. ____________________________________
2. ____________________________________
3. ____________________________________
4. ____________________________________
5. ____________________________________
NOTICE TO ALL EXHIBITORS.
Please price all merchandise in your booth that is for sale. All games must be set to FREE PLAY AT ALL TIMES.
NO exit moving until 4pm on Sunday. There are no exceptions! Payment in full must accompany this form.
I have read and understand all the of the rules regarding exhibiting at Pinball Expo and agree to them.

Signature:_______________________________________________ Date:______________
Send check or money order (U.S. funds only) payable to:
PINBALL EXPO, 1085 Eagle Trace, Warren OH 44484
330-369-1192 or 800-323-FLIP, 330-369-6279 Fax. [www.pinballexpo.net]