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VENDOR APPLICATION TO PRINT AND MAIL WITH CHECK
or USE ONLINE FORM BELOW
NAME______________________________________________
ADDRESS___________________________________________
CITY____________________STATE_____ZIP
CODE_________
PHONE(____)____________EMAIL_______________________
NUMDER OF 10'x15'
SPACES REQUIRED_____@ $20.00
PER SPACE
TOTAL ENCLOSED
$__________
CREDIT CARD
NUMBER_______________________________
EXPIRATION
DATE__________VISA___M/C___DISCOVER___
TYPES OF MERCHANDISE
TO BE SOLD__________________
___________________________________________________
IF PAYING WITH CHECK
SEND APPLICATION WITH CHECK To ADDRESS BELOW
OR CALL IN CREDIT CARD INFO TO Tom Guest at: 386-673-6009 / 386-295-7999
Or Email--------taustin1945@gmail.com
MAKE CHECK OUT TO:
Choppers World
and send to:
Choppers World
721 Garden Lane
Ormond Beach
FL 32174
CONFIRMATION WILL BE
SENT TO YOU
