Vendor Registration April 17, 18 & 19, 2009

Print and complete the form and fax or mail to the address below.

Company Name_______________________________

Company Rep ________________________________

Address _____________________________________

City_________________________________________

State _______ Zip Code ____________________

Phone _______________________________________

Fax _________________________________________

Email ________________________________________

Do you need? (check if needed)

120 v power ________ (you must bring your own extension cords)

10 X 10                                                                            $375.00

10 X 10  Corner open to 2 sides                                      $450.00

Large Corners or larger areas – call for price.  Only 4 Available

Amount Due:

Booth Size ___________ ...............................................Amount $______________

Deposit (50% non-refundable, required).........................Amount $______________

Other..................................................................................Amount $______________

Balance Due (due by February 28. Late fee $25.00).....Amount $______________

MC, Visa,  or Discover       or send check or money order to :

Wyoming Home Show

P.O. Box 6783

Sheridan WY 82801

or FAX to: 307-655-5014

Card Number__________________________________           

Expiration date ______________________          

CVC # back of the card ________________         

Signature___________________________          

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