Vendor Name *

First Name

Last Name

Vendor Name (if more than one rep)

First Name

Last Name

What best describes you?

I am a crafter

I represent a national brand

I provide local services

Other

Phone *

(###)

###

####

Vendor Needs-check ALL THAT APPLY: (table space DOES NOT include a table, it is your vendor space only)

1 Table Space $50

2 Table Spaces $75

3 Table Spaces $110

I work from back side of the table(s)

I work from front side of the table(s)

I work from both sides of the table(s)

I need electricity - bring own extension cord ($10)

I will bring my own table(s)

I need to rent 1 table ($20)

Check All That Apply

I would like to donate an item to the door prize drawing

Date

MM

DD

YYYY