46th Annual Claxton Rattlesnake & Wildlife Festival March 9 & 10, 2013 Commercial Vendor Application

Return to: Evans County Wildlife Club PO Box 292, Claxton, GA 30417 Phone: (912) 739-3820 Fax: (912) 739-3827 [email protected]

Entry Deadline – February 15, 2013. $10 Late Fee, provided space is available. Please print or type legibly. Complete and return with photos (if first time vendor) and payment.

Contact Name ______

Company Name ______

Mailing Address ______

City ______State ______Zip Code ______

Phone (Home/Business) ______Fax # ______

Cell Phone ______

Website ______

Email Address ______

Please provide description of ride, inflatables, amusement, etc. including set-up.

Quantity Amount Due

______16’Wide X 10’ Deep (Outdoor Space) @ 15% commission post event, with a minimum of $500 $ ______

This information is for Evans County Wildlife Club’s use only.

Date Application Rec’d ______Rec’d by ______

Application Approved ______Denied ______

Date Notified ______Notified by: Phone ______Mail ______Email ______

Exhibit Location # ______

Amt Rec’d $ ______Check # ______Money Order # ______Cash ______