Rooted in Faith Vendor Night – Vendor Registration Form Email(Required) Business Name(Required)Name(Required) First Last Description of Business(Required)Item(s) being sold(Required)Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Do you need an eletric outlet?(Required) es, and I will bring my own minimum 50 ft extension cord No Consent(Required) I understand and agree the St. Thomas Diocese, St. George Chaldean Catholic Church, nor its staff, volunteers, priests and affiliates may be held liable for any occurences in connection with this event which may result in injury, harm, or damagesSignature(Required) First Last
