Vendor Registration Form - Autism Ontario

Apr 22, 2016 - ... person/plan in the event I am not able to physically attend GN 2016 myself. Signed by___________________________________on (date)
NAN Sizes 9 Downloads 103 Views
for office use:

Vendor Registration Form Girls Nite for Autism 2016 The evening of Friday April 22nd 2016 at the Ajax Convention Centre

Name of registrant:_______________________________________________________ Company name:_________________________________________________________ Company type:__________________________________________________________ I would like to donate an item for raffle/ fee of $200

or

I do not wish to donate an item for raffle/ fee of $220 I wish to add an item to the swag bags. Item description:____________________________

Registrants mailing address:_________________________________________________ Registrants email address:__________________________________________________ Please provide a reliable contact number:_____________________________________ Have you previously participated in one of our events?____________________________ If yes, please give the name and year _________________________________________ What will you be selling?____________________________________________________ Can any of your items be considered “adult only”?________________________________ I agree to a deposit of $100 remitted by November 30th, 2015 (non refundable): YES NO I agree to remit the balance owing by March 1st, 2016: YES

NO

I understand that Autism Ontario Durham Region cannot guarantee exclusivity to any vendor and that no preference shall be given to table placements. I agree to remit my donated raffle item by March 1st 2016 (if you have chosen this option). I understand that my deposit will not be refundable after November 30th (should I decide to not participate). I agree to have a backup person/plan in the event I am not able to physically attend GN 2016 myself. Signed by___________________________________on (date)___________________