ALL Personal Information fields are required and must be completed.

PERSONAL INFORMATION
FIRST NAME:	LAST NAME:
HOME PHONE:	CELL PHONE: *Can be same as home phone.
eMail:	ADDRESS:
CITY:	POSTAL CODE:
BUSINESS INFORMATION
ARE YOU A: Food Vendor    Non-Food Vendor
BUSINESS NAME:
BUSINESS LICENCE:	VALID IN VICTORIA: No    Yes
SOCIETY NUMBER: *required for non-profit rate
BOOTH TYPE: ==SELECT== Non Profit & Non Food Vendor - $10.00 Profit & Non Food Vendor - $20.00 Profit Food Vendor - $30.00 + 10% of Gross Sales *If you choose to pay by Pay-Pal, and you are a Profit Food Vendor, you will be charged $30.00 now, and your gross sales will be invoiced after the festival.	NO. OF TABLES REQUIED: ==SELECT== 0 1 2
PAYMENT METHOD: ==SELECT== PayPal Cheque
CONFIDENTIALITY AGREEMENT I authorize the Victoria Pride Society to collect and maintain the above personal / business information. This information may be used to contact you to confirm your responses. My name and address will be retained on file. My information will be used for these purposes only and shall be held in strict confidence. By clicking the submit button, you agree that you have read and understood the above mentioned agreement. Clicking submit is considered the same as a physical signature on a paper agreement.