CCUS On-site Contact and EAC Work Authorization Form

On-site Contact and EAC Work Authorization
(To be completed by Exhibitor)

Please name an authorized contact person or persons who will be on-site during move-in, exhibition open hours, and move-out. They will be responsible and authorized to discuss and resolve any situation that may arise concerning your exhibit and make all necessary decisions.

Questions? Contact Teresa Dallis

Exhibitor Information

Company Name *

Booth #

Primary On-Site Contact Person *

Mobile Telephone (including country code) *

E-mail *

Additional On-site Contacts

Contact Person (1)

On-site Phone/Mobile (including country code)

Contact Person (2)

On-site Phone/Mobile (including country code)

Contact Person (3)

On-site Phone/Mobile (including country code)

EAC (Exhibitor Appointed Contractor) Work Authorization

Do you plan to use an Exhibitor Appointed Contractor (EAC), other than Freeman to build/construct your booth? *

Yes

Unsure at this time

EAC (Company name) *

EAC Contact Person *

EAC On-site Phone/Mobile (including country code) *

EAC Email Address *

Using more than one Exhibitor Appointed Contractor (EAC)? *

Yes

EAC (Company name) *

EAC Contact Person *

EAC On-site Phone/Mobile (including country code) *

Addl EAC Email Address *

Email of person who should receive confirmation of form completion. *

Please click the Submit button to send.