REGISTRATION FORM                                                                                           http://www.czech-slovak-festival.com/

LEGAL NAME:                                                BUSINESS NAME:_______________________

FEDERAL ID (IF ANY)______________________________________

ADDRESS:_________________________________________PHONE-NO: ______________

SOCIAL SECURITY # OR SELLER’S PERMIT #              ________________    

                                      

TAX EXEMPT UNDER THE OCCASIONAL SALES RULE (LESS THAN $1000 A YEAR SALES):      YES/NO

 

ARE YOU A NON PROFIT ORGANIZATION:        YES/NO

 

TYPE OF CRAFT OR ART:                                                                                                                           

                                                                                                                           _______                            

 Enclosed is $__________ for [ appropriate selection (s)]

______      1 day, 1 space $35.00

______      1 day, 2 spaces $60.00

______      2 days, 1 space $60.00

______      2 days, 2 spaces $100.00

______      All additional space $25.00 each per day

____        Number of extra spaces needed

Make check payable to:  PHILLIPS CZECH-SLOVAK COMMUNITY FEST 

Send form & check to:                         William Moravek

N8691 Storms Rd,  Phillips, WI 54555

wdkm@aol.com

  715-339-2623

I understand that I do not hold the Phillips Czech/Slovak Community Festival, Inc. responsible for any loss or damage.  

Signature:                                                         

EMAIL Address: ___________________________