C.A.R.E. Neighborhood Watch

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Vendor Registration Form

Aug 29, 2004

Name:__________________________________________

Business Name:__________________________________________

Business
Address ________________________________________

Phone Number ( )___________________
Cell Phone Number ( )___________________

Type of Business:

____Retail ______ Sales ______Service

____Technology ______Commercial _____Religious

____Public Service

Other (please list)_________________________

Food/ Beverage (please list)_________________

Booth Space Desired:

1. _______ Single- One regular table
2. _______ Double- Two regular tables
3. _______ Triple- Three regular tables

Signature ______________________________________
Date _______________________________________