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AUTOMATION FAIR 2022
REGISTER TO TRAVEL WITH US
First Name
*
Last Name
*
Company/Organization
*
Job Title
Email Address
*
Account Manager Name
Mobile Phone
*
Work Phone
*
Registration Type
*
Van Meter Employee
Van Meter Customer
Van Meter Supplier
Where are you located?
*
Iowa
Minnesota
Wisconsin
Other
Emergency Contact Name
*
Emergency Contact Relationship to you
Emergency Contact Phone Number
*
Travel Package
*
One-Night Automation Fair - $500/person
Hospitality Only - $150/person
Would you like Van Meter to book your airfare?
*
Yes
No
Payment Method
*
Check
Credit
Purchase Order
Purchase Order Number or Credit Card Type
Do you have any dietary restrictions/allergies that we should know about to accommodate you for our networking event?
Yes
No