Crepe Myrtle Application

Name

Email Address

COMPLETE NAME OF CO

MAILING ADDRESS

City

Cell Phone

Type of Entry Type of Entry NON-PROFIT HANDMADE PRODUCTS SALES COMMERCIAL (INFORMATION ONLY) COMMERCIAL SALES (NO FOOD) FOOD VENDORS POLITICIANS

Electricity Electricity 110v -$15.00 220v -$25.00

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COMPLETE DESCRIPTION OF CRAFT/FOOD:ListALLitems to be sold.If you sell items other than listed, we have the right to ask you not to sell it:

LIABILITY INSURANCE POLICY NAME & NUMBER IF FOODVENDOR:

24 E. Depot St.
PO Box 47 Angier
North Carolina 27501
Phone: 919-639-2500
Fax: 919-639-8826