SHATTER THE STIGMA

VENDOR/SPONSOR REGISTRATION FORM

(Please Print)

Name of Company/Vendor:

Date:

CONTACT INFORMATION

First:

Middle:

Last:

Street address:

Phone:

Cell Phone:

City:

State:

Zip:

Email Address:

EVENT INFORMATION

Product/Service Details

Product/Services offered:

TSHIRT SPONSOR

$100

Setup Details

Will you be setting up a tent and display table?

If yes, how many (10x10’) spaces do you require for the display?

Would you like to include any give away in our car show bags?

Would you like to sponsor trophies? $50 _____ $100 _____ $250______

PRICING INFORMATION

Single Vendor Space (10x10): $75 Early Registration (02/10/2016)

$100 After Feb. 10, 2016

Quantity Required

Non Profit Entity (501 (C)3 Status $ 0.00 Early Registration (2/10/2016)

$50.00 after Feb. 10, 2016

Quantity Required