Name: _________________________________________________________

Address: _______________________________________________________

______________________________________________________________

Phone: ______________________

Fax: _______________________

Email: ______________________ Website: ________________________

Types of Merchandise:
________________________________________________________________

________________________________________________________________

________________________________________________________________

Fees:
12 X 12 Booth $100.00   12 X 24 Booth $150.00   Booth $____________
Electrical $15.00 per Booth                               Electrical $_________
Town of Bell Buckle Vendor Fee                                             $15.00

                                                                      TOTAL: $_________