Global Vending Machine Firm Registration Form
                

 
Date: Title/Position: 
   
   
Company: Phone & Extension:
 
   
Contact:  Cell:  Email Address: 
    
   
Address:  Web Site Address: 
   
Address 2:   Emergency Contact:
   
City/Town:  Country:
 
   
State/Province/Prefecture:   
   
   
PO Box Address:   
 
   
VENDING MACHINE CATEGORY–A
(Inside Tent)Cash Machine Cigarette Machine Condoms Machine Others
   
VENDING MACHINE CATEGORY-B (Inside Tent)
Coffee Machine Nuts/Snacks Machine Soft Drinks Machine