Name Business Name

Address City/State/Zip

Phone    Email

Website

Booth Space Rental Fee:

10X10 Booth Space $40.00   Each Additional Space (10x10) $40.00   Electricity $30.00

Do you require electricity?   Voltage

(If yes, please list your electrical needs and the voltage required for each item that will require electricity. You will be responsible for extension cords and any other electrical connections needed. Extension cords must be HEAVY DUTY! You must specify you voltage on application. (20Amp Service is all that will be available)

Please list the products in which you are going to sale:

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Select Payment Method:    Check Enclosed Money Order Enclosed

Signature: _____________________________________________    Date: ________