Orange Show On Line Application

Orange Show Quick Vendor Application
Past Vendor:
What year:
If you have spoken with one of our account represenatives please select the name from the box below.
*Sales Rep:
*Business :
*Contact :
*Address:
*City:
*State:
*Zipcode:
SalesTax #:
Phone #:
Fax #:
E-mail :
*Product or Service description. All products must be listed:
When selecting an indoor booth please select 3 different choices if none of your choices are available we will contact you with the closest choice.
Indoor choices :
Outdoor size:	10x10 10x20
Outdoor area:	Prime Main Walkway Showtime
Outdoor Corner:
The credit card billing name and address must match the name and address you entered above.
*Amount to charge:
A deposit of at least 50% is required
*Card type:
*Card #:
*CCV#:
*Exp. Date:
*Year:
I here-by authorize R.G. Canning Ent. Inc. to charge my credit card for the amount shown.
My signature will be replaced by a 6 digit passcode I will enter.
*Passcode: