Vendor Registration – 2019 Music Festival Name* First Last Business Name*Phone*Email* Website Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code This should match your cardholder address if paying by credit card.Previous Vendor?*YesNoCategory of Items for Sale* Bath/Body Products Beeswax Items/Candles Clothing-Adult Clothing-Children Clothing-Accessories Food Items Glassware Holiday Decorations Jewelry Pottery Sculpture Toys Wall Art Woodcarving Other (please specify) (check all that apply)If other, please describePlease select space*Standard site 10'x10'Total $0.00 Acknowledgements (Please read and check the following statement before submitting this form). Read Terms and Conditions* I agree to the Terms and Conditions Credit Card American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20192020202120222023202420252026202720282029203020312032203320342035203620372038 Expiration Date Security Code Cardholder Name
