Name: __________________________________________________

Business Name: __________________________________________________

Address: __________________________________________________

City, State, Zip: __________________________________________________

Phone: __________________________________________________

Cell Phone: __________________________________________________

Fax: __________________________________________________

Email: __________________________________________________

Website: __________________________________________________

Please give a brief description of what you will be selling: __________________

____________________________________________________________________

____________________________________________________________________

How many 10X10 spaces do you need? (Cost is $50.00 per space for weekend) $ TOTAL

Spaces___________________@ $50.00 each = $___________________ $ __________

Do you need electricity? Circle one YES-110 YES-220 NO

Do you agree with the vendor policies? Circle one YES NO

How did you hear about us? Web site Flyer Word of mouth Other