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BOOTH APPLICATION

NORTH FORK EARTH DAY


Saturday, April 16, 2011 10:00 AM – 3:00 PM
LOCATION: NORTH FORK MILLSITE
Contact: Diann Miller 877-4620 or djmiller@netptc.net
REPRESENTATIVE NAME: ORGANIZATION:

MAILING or E-MAIL ADDRESS:

TELEPHONE: CELL/MESSAGE PHONE:

TYPE OF BOOTH: Please circle

FOOD ARTIST INFORMATIONAL OTHER:


BUSINESS EDUCATIONAL TRIBAL/CULTURAL
RUMMAGE FUNDRAISER HANDS ON ACTIVITIES

NOTE:
All food vendors will need to submit an application for a temporary health permit from Madera County. Applications
are due to the County by APRIL 1.
http://madera-county.com/envhealth/#foodsafety

ALL VENDORS MUST HAVE THEIR BOOTH APPLICATION IN BY APRIL 1, 2011.

Vendor must supply own tables, chairs & canopy. Does vendor need electricity/special needs? Please note:

FEES
$40.00 per booth
OR All donations will
$20.00 and a donation that is equal to $20.00 be used to build funds for a
scholarship for a
High School
Please make checks payable to: ALL VENDORS MUST student who is interested
North Fork Earth Day PROVIDE OWN in Natural Resources
Mail to Diann Miller LIABILITY INSURANCE
P.O. Box 1109
North Fork, CA 93643

The booth representative acknowledges that they have the necessary insurance to participate at this event.
SIGNATURE: DATE:

APPLICATION RECEIVED BY____________________________


DATE/TYPE OF PAYMENT/CHECK NO.___________________ Deposit date & initial__________________

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