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VENDOR APPLICATION Download form at the bottom Business Name: ________________________________________ Your Name: ______________________________ Address: __________________________________ City: _______________________________State ____________ Zip: __________________ Phone: ______________________________ Email: _____________________________ On Site Contact Person: _______________________________________ Cell #______________________________ Arrival Date: _________________________Type of Vendor: _____________________________________________ SPACE SIZES AVAILABLE: Type of Vehicle Total Length 20’ x 20’ (Minimum) ---- $100.00 ___________ ____ Tractor trailer ____________________ 20’ x 30’ ------------------- $150.00 ___________ ____ 5th Wheel trailer________________________________ 20’ x 40’ ------------------- $200.00 ___________ ____ Motor Home____________________________________ 20’ x 50’ ------------------- $250.00 ___________ ____ Pickup Truck___________________________________ 20’ x 60’ ------------------- $300.00 ___________ ____ Pickup Truck & Trailer__________________________ 20’ x 70’ ------------------- $350.00 ___________ ____ Automobile____________________________________ 20’ x 80’ ------------------- $400.00 ___________ ____ Motor Home w/Trailer___________________________ 20’ x 90’ ------------------- $450.00 ___________ ____ Motorcycle w/Trailer____________________________ 20’ x 100’------------------ $500.00 ___________ ____ Other /explain__________________________________ 20’ x 110’------------------ $550.00 ___________ ___________________________________________________ 20’ x 120’------------------ $600.00 _______________________________________________________________ No. of power plugs ______x $35.00 ___________ Number of worker armbands needed_____________ FULL Rally Reg._______ x $25.00 ___________ TOTAL FEES ____________ VENDOR INFORMATION SHEET Notice: Each Vendor will be required to show Proof of Valid Liability Insurance before entering Vendor Area. If your towing source stays with the vending source, you must also purchase enough space for the towing source.) Check one. I plan to keep my towing source at Vendor Site_______ or move it to another area_______ Explain what will be in your vendor space while open at the rally______________________________________________________________________________ You will be assigned a site prior to your arrival. If you are not in line for the Wed. pm or Thurs. morning Vendor set-up, you will forfeit the site assigned. If you know that you will be a late arrival, please indicate the date of your arrival___________________. You will be issued a vendor number when we receive your registration form and Vendor fee. This is the number we will use to call you into line for placement into the Vendor area Wednesday pm or Thursday morning.
I have read the above information and understand the requirements and restrictions. I agree to abide by them all. Signature: ______________________________________________________ Date: __________________________ Click here for Word format Click here for PDF format Form Instructions 1- Download the form, print and fill it out to mail. 2- Include Credit Card info, check or money order. 3- Mail to: Bobby Patterson 2247 Hwy 35 S. Foxworth, Ms. 39483
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