2018 Vendor Contact Information
Email address *
Type of Registration *
Business Name *
Your answer
Vendor Name *
Your answer
Phone number *
Your answer
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Vendor Category (Items must be Homegrown, Homespun or Homemade) *
Required
Vendor Category: If other please describe
Your answer
KS Dept of Revenue Retailers Tax License Number *
Your answer
Other Licenses Numbers (KDOA Mobile License, Wholesale Meat Dealer License, Food Processor License, etc.)
Your answer
Year *
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