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 _____