Newberry Community Center & Park July 3, 2016 Fireworks 
Contact – Jodi Howard- Newberrycsd@gmail.com
Phone-760-257-3613 
Application For Vendor Space

	Application Date: 	_ 

 Companyllndividual: 
Mailing Address: 
Phone: 
Contact Person (Person in charge of Booth): __________________________________________________________________________

Email:________________________________

Number of booth Personnel Including Yourself 
Food Vendors(List ALL Food Items for Sale): :_____________________________________________________________________________________________________________________________________________________________________________ 
Product or Service General Description: 

Booth(s) Requested: 

@
	$ 	= $ 	Total Due 
---_. ._---- ---- 

	Booths are $10.00    Food Vendors 1 booth is $30 	Multiple booths are $20ea 
Booth fees must accompany application/Food vendors must have Valid Health Permits.
Special Requests or Needs? (i.e. electricity) 
We will attempt to meet your needs as much as 
possible. It is your responsibility to confirm 
special requests. 
Note: Our cleanup crew is paid by the recyclables they gather during and after the Festival. 
***** Do not collect recyclables from the Festival.'?"?" 

Please Return Completed Application 
with your Remittance to: 

Newberry Community Services District
Attn: Jodi Howard
P. O. Box 206
Newberry Springs, CA 92365 

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ 

For Chamber Use Only: 

Date Received: 
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Space Number Issued: 
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Name on Check (If Different from Applicant): 
Notes/Comments: 

Amount Received: 
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