Vendor Application Page: HORSE Smoke Out 13 (2012)
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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  _____