Reservation Request

Spudmobile

Reservation Request

"*" indicates required fields

Event Information

Event Name*

Event Address*

Street Address Address Line 2 City State ZIP Code

Event Date*

Alternate Event Date

Event Start Time*

Event End Time*

Anticipated Attendees Per Day*

Contact Information

Requesting Organization*

Name*

First Last

Phone Number*

Type of Event

Please select one type of event below.*

Potato Industry Related

Community

Retail Store

School

Please provide store name.*

Please provide school name.*

Grade Level(s)*

Number of Classes*

Number of Students*

Event Description

Please provide a brief description of your event and its intended purpose.*

The Spudmobile has attended this event before.*

Yes

Former Event Date*

No

Spudmobile Requirements

Your venue must be able to accommodate the following specs and clearance requirements to safely exhibit the fully extended Spudmobile at your school, museum, retail location, public area, or special event:

• Minimum space requirement: 30' by 40'
• Clearance: 14'
• Interior height (floor to ceiling) 7'

The Spudmobile requires a 50 Amp 220V (4 Prong Plug) for electricity within 100 feet of the unit. If electric service is not available please contact WPVGA at 1-715-623-7683 to discuss alternative power sources.

Acknowledgement*

I, the contact person, acknowledge that I have read and agree to the rules and terms set forth by the WPVGA and Spudmobile staff in the Wisconsin Spudmobile Exhibitors Agreement. I acknowledge that I represent the Requesting Organization, and that I have the authority to bind the Requesting Organization to the rules and terms in the Exhibitors Agreement.

The WPVGA will contact the Requesting Organization's contact person after it reviews your Event Registration request, and confirm the booking if that date is available. WPVGA will make that confirmation by phone or email.

2157

Reservation Request

Spudmobile