Vendor Application Page: HORSE Smoke Out 13 (2012)
 (Return this page only)

We, the undersigned, do hereby submit our application for one (1) display space as an exhibitor at the Smoke Out June 22-23, 2011 Rockingham, NC; subject to conditions and regulations governing the event and its production. 

 

Booth Size: ____________________________

Company: _____________________________________________________________________

List Items to be Sold or Exhibited: __________________________________________________

 

_______________________________________________________________________________

 

E-mail: ____________________________ Contact Name: ______________________________

Telephone: __________________________________Cell Phone: ______________________________

Address: ______________________________________________________________________

City, State, Zip: ________________________________________________________________

By signing below I acknowledge, agree and accept that I am strictly forbidden to sell or give away anything that refers to the Smoke Out, FBI or THE HORSE, B.C. Magazine.   I understand vendor space comes with no wristbands and vendors must purchase wristbands to enter the event area. 

 

Signed: ____________________________________________Date: ______________________
                                    Must be signed to validate contract.

Signed: ____________________________________________Date: ______________________
                        Greg “Edge” Scheuer, FBI                            
                        PH # (803) 210-7272                                               
                                                                                               
Make Check Payable to: “Flat Black, Inc. 
                   
Send To:  Flat Black, Inc
100-3 Forum Dr Suite #163
Columbia, SC  29229

Note: The signed returned copy of this form is your proof of registration.  Thank you.

Office Use Only:

Total Fee _______  Deposit Paid _______ Chk # _______  Balance Due _______

Date Balance Paid  _______  $ _______ Chk # _______ Paid in Full  _____