Mobile Shop Request Form

Apply to host a mobile shop at your event!
Service Unit/Department
Requester's Name

First NameLast Name
Event Name
Event Date and Time

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Event Duration
Event Location (Full Address)

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Estimated Attendance (Youth)
Estimated Attendance (Adults)
Event Type
Is the event indoor or outdoor?
Will electricity be available on-site?
Will tables be provided at the event?
Promotion Plan (How will you encourage shopping?)
Contact Person Onsite (Full Name)

First NameLast Name
Contact Person Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact Person Email Address
example@example.com
Are you interested in offering pre-orders for this event?
Do you have any special merchandise requests?
Should be Empty:

Apply to host a mobile shop at your event!