EmailMe Form - Market Vendor Registration

Business Name

Contact Name

First Last

Tax ID #

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Business Phone

### - ### - ####

Cell Phone

### - ### - ####

Email

Web Site

Detailed Description of Goods/Servicesy you wish to sell

Market Vendor:
# of booths needed

Electricity Needed
Additional $20

*only one 110 per vendor*

List any and ALL items you wish to power. Items will be checked during event.

Special Needs

You may indicate a special need but we are not obligated to guarantee these requests.

Select Payment Amount

$25 Booth Fee

$45 Booth Fee + Electricity