Organization Name:_______________________________________________________

Contact Name: ___________________________________________________________

Address: ________________________________________________________________

Contact Numbers: ________________________________________________________

                                    (Home)                                                     (Work)                                                    (Cell)

Are you selling a product?                     Yes          No

Are you selling perishable goods?          Yes          No

If yes, your booth must be approved by the City County Health Department.

Will your booth require electricity?        Yes          No

If yes, you provide your won generator. The generator must be approved by the City Code Enforcement Officer and must not create a noise nuisance.

If you are selling a product, the Vendor Booth Participation fee is $20.00 and remittance of sales tax will be required by city ordinance and state law. Please contact the City Clerks Office at 771-3226 for more information.

Description of Booth

     ____________________                                                               __________________

     Signature                                                                                         Date

RETURN FORM TO:

Karen Scovill, Attn: Unity Day

P.O. Box 660

Spencer, Oklahoma 73084