30 Ways
2016 Vendor Application
And Agreement
April 6th– 7th, 2016
Company Name:________________________________________________
Contact Person Name and Title:____________________________________________________________________
Street Address:____________________________________________________________________________________
City:
State:
Zip Code:
Business Telephone:_________________________________
Contact cell phone:____________________________
E-Mail:____________________________________________
Goods or Services to be offered:_____________________________________________________________________
Insurance carrier:
Policy Limit:$
VENDOR SPACES: Below, please indicate your desired space selection:
BR $250:______
Bronze - $400:______
Silver - $600:______
Gold $800:_______
Platinum-$1000_______
PLEASE NOTE – All Vendor spaces include 2 vendor passes.
Electrical Service requested: YES _________ or NO ___________
50% due to lock in space- Pay in full by March 16
Pay in full before March 1st, 2016, DEDUCT $25.00
$
TOTAL DUE: $
TOTAL PAID: $
Email payment via PayPal to: [email protected]
For additional payment plan(s) email at [email protected]
For alternative forms of payment(s) outside of PayPal email at [email protected]
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