Vendor/ Agency *

Contact name *

Address/ Zip *

Contact Name at Booth *

Phone Number *

Fax Number

E-Mail Address *

Notice: Vendor/Agency please submit your number of volunteers or assigned staff members.

Number of staff/ volunteers *

We provide the following equipment if necessary.  Please check if needed.  Thank you.

6' banquet table (if needed) Yes No

2 chairs (if needed) Yes No

Please enter the name of person completing form.  By entering your name, it will serve as a signature to our Vendor Application.  If you have further questions, or want to know more about events not listed on this application, you can contact us via email or give us a call at (702) 393-6163.  For additional information on your specific event, please review the event details on our Website.  Thank you.

Signature *

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