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Moniteau County

Back to School Fair Booth Request / Registration Moniteau County Back to School Fair 10a – 3p., Saturday, July 28, 2012 1501 W. Buchanan St.; California MO (California High School)

Booth rental cost: Space includes: 1 8ft table and two chairs $15 for early bird registration (before July 1, 2012). $25 after July 1st. **Military, Fire, Police, Emergency displays exempt from rental fee** Please return this form & payment to Alicia Whitson 304 Deblee Dr; California MO 65018 or email it to Alicia.whitson@gmail.com with purchase order number.

Name of Organization / Agency: _______________________________ Contact Person_____________________ Mailing Address:_____________________________________________________________________________ Contact Phone#: __________________________ Contact Email: ______________________________________ Describe your product or services please also note any special requirements (electricity, water, floor space, outdoors, etc) ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ ___________________________________________________________________________________________ Name to be placed on booth / newspaper announcements (if blank , we will use the name of agency): ___________________________________________________________________________________________ ___________________________________________________________________________________________ By reserving booth space, I am agreeing to be responsible for my own equipment, set-up (check-in begins at 8am.), maintenance and management of the booth between the hours of 10am & 3pm., disassembly of the booth & clean-up of the booth area by 3pm. I understand that the Moniteau County Back to School Fair is NOT responsible for items damaged, lost, etc, during this event. X___________________________________ Date:__________________________


BTSF vendor form