Vendor Registration Form

Saturday, December 10, 2023
Vendor Registration

Complete form below to signup as a vendor.
Company Contact Information
Organization/Business Name*
Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Point of Contact*

First NameLast Name
Phone Number - Mobile Preferred*

Area CodePhone Number
E-mail*
Company Overview
Vendor

Community Resources/InformationPublic SafetySocial ServicesMentorshipAdvocacyFood Truck
General Details of Services/Goods
Establishment Date

MonthDayYear
Date
Geographic Service Area
Business Type
Insured?

YesNo
Licensed?

YesNo
License Number
IMPORTANT INFORMATION
- Electricity is not included
- We recommend a cashless environment (CC sales, cash app, etc.)
- All vendors are responsible for branding, decorating your space, wifi, electrical cord and lighting.
- All vendors are responsible for providing your own: one (1) tent, one (1) table, and two (2) chairs. Tents/booths must be not be larger than 10x10.
- Booth locations will be assigned by 509 Community Committee
IMPORTANT TERMS & CONDITIONS
Terms & Conditions*

I agree to the terms and conditions.
I hereby affirm that all information provided above is accurate to the best of my knowledge and belief, and I understand that this information will be considered material in the evaluation of vendor participation in this event.
Date

MonthDayYear
Date
Company Representative Signature*

Clear
Should be Empty:

Saturday, December 10, 2023