Effluent Expo NZ Contact Information and Booking Sheet

Site spaces are limited and will be assigned on a ‘first in first served basis’. Please note all correspondence and invoicing will be emailed only unless otherwise requested.

Please contact us here with any questions you may have on the below form. Please note, * denotes a required field.

Exhibitor details


Company name

Company name (Legal)*

Company name (Trading as)*

Site details contact person

Full name*

Role title*

Phone no. (incl. area code)*

Mobile no.*

Email address*

On the day contact person

Full name*

Role title*

Phone no. (incl. area code)*

Mobile no.*

Email address*

Postal address*

Post code*

Street address*

Post code*

Account details for invoice


Account name*

Contact name*

Type of business*

Phone no. (incl. area code)*

Postal address*

Post code*

Remittance email address*

The Effluent Expo is strongly focused on the subject of effluent storage, design, its management and application to industry minimum standards.

We therefore reserve the right to accept or reject applications for a stand on this basis.

Please describe below the relevance of your stand to the Expo, and the way in which your business contributes to supporting farmers to improve their effluent management.*

Has your business had any altercation with any regulatory authority in and around design or functionality of your product – if so, please explain.

Other details


Do you want to reserve a place at the relaxed industry function (4.30pm – 7.30pm Tuesday 27th November at Mystery Creek)?*

YesNo

NZ Dairy Exporter is our official media partner and will be producing the Official Expo Guide for every dairy farmer in the country. One of their team will be in touch to discuss promotional opportunities in the Official Expo Guide and NZ Dairy Exporter. Please tell us who is the best person in your business to deal with this.

Name*

Phone*

Indoor sites


You can view the map here.

Do you require an indoor site?*

YesNo

Site sizes and cost excl.*

Extra: Trestle Table 1.8m and cloth; Cost: $35ea*

Extra: Trestle Table 2.4m and cloth; Cost: $55ea*

Extra: Chair; Cost: $6ea*

Indoor Exhibition Site Selection (provide site number in order of preference)

Set-up time*

Do you require a forklift required during set-up?*

Pack down date and time*

Do you require a forklift required during pack-down?*

Do you require electricity? (see condition 5)*

YesNo

Is 10AMPS sufficient? (if not see condition 5)*

YesNo

Do you have any large items (over 100kg) on your site? If so, please provide details

Outdoor sites


You can view the map here.

Do you have require an outdoor site?*

YesNo

Site sizes and cost excl. GST*

Which is your preferred site selection, and do you require power to your site (is 12A sufficient)?*

Set-up time*

Do you require a forklift required during set-up?*

Pack down date and time*

Do you require a forklift required during pack-down?*

Any other requirements / comments?


Please add any other requirements / comments here.

Liability insurance requirements


Do you hold Public Liability Insurance of not less than $2m*

YesNo

Please provide further details*

Type of insurance*

Provider*

Policy number*

Date insurance valid from*

Date insurance valid to*

Upload Certificate(s) (Format: PDF / Limit: 10MB each)

X

X

X

X

+ Add another file

Health & safety requirements


Tasks performed on site*

Potential hazards / Harm on site e.g. Operating machinery, slips trips & falls - risk of bruising, broken bones etc.*

Action taken to eliminate, isolate or minimize hazards*

Other comments

Confirm & agree


Name and Position*

Date*

View Agreement for Exhibitors*

The person submitting this agreement confirms that they have the authority to sign for and on behalf of the Exhibitor and have read and understood the Agreement for Exhibitors linked above.

Please wait for a few seconds for system to confirm success message. Please do not press 'SUBMIT' more than once.