Northern Colorado Intertribal Powwow Association
Fall Contest and Fundraising Powwow * October 11, 2008
Northside Aztlan Community Center; Fort Collins, CO
Artist / Vendor Application
Artist / Vendor Information:
| Name: | Tribal Affiliation: | |
| Company: | Tribal Census No: | |
| Address: | ||
| City, State, Zip | ||
| Telephone (day): | (evening): | |
| E-mail Address: | ||
| Website: | ||
| Name of "helper" - for badge | ||
Brief description of items to be sold (required):
___________________________________________________________________________________________
Booth Spaces:
| _____ | spaces x $50/ space = | $_________ | if postmarked by September 26, 2008 |
| _____ | spaces x $75/ space = | $ ________ | if postmarked September 27, 2008 and later |
| NCIPA Vendor Coordinator P. O. Box 1938 Fort Collins, CO 80522 |
If you have any questions, please call Deb Wadena at (970) 224-2356. |
I have enclosed: Check #________________ Money Order #:________________ Amount:__________
Vendor: My signature below confirms that I have read and understand the vendor agreement, and I agree to abide by all rules and regulations stated thereof. [If Vendor is a corporation or other organization: I certify that I am authorized to sign for and bind such corporation or organization to this agreement and that I have signed in the capacity of for such corporation or organization.]
Vendor's Signature:_______________________________________________ Date: ______________________
| For Committee Use: | ||
|---|---|---|
| No: | Postmark: | Balance Due: |
| Comments: | ||