Antique Equipment Display Form

OWNER'S NAME:  ______________________________________________________

             ADDRESS:  ______________________________________________________

               CITY/ZIP:  ______________________________________________________

           PHONE NO:  ______________________________________________________

If being displayed by someone other than owner,

     DISPLAYED BY:  __________________________________________________

TYPE OF EQUIPMENT:  _________________________________________________________

YEAR (if known):  _____________________________     

MODEL (if any):  _____________________

ADDITIONAL INFORMATION: 

_______________________________________________________________________________

Mail Form To: Summit County Fair PO Box 89 Tallmadge, OH  44278   or   Fax Form To: 330-633-2518