Ukrainian Day At Giants Stadium Vendor Application

Saturday September 17, 2005

10:00 a.m. - 6:00 p.m.

Space Available 10’ x 20’ - Fee $ 200.00

Business Name: ________________________________________

Contact Name: ________________________________________

Address: ________________________________________

City: ____________________ State: __________ Zip: _______________

Telephone: _________________________ Fax: _________________________

Email: _________________________

Liability Ins. Carrier (Mandatory / Food Vendors Only):___________________ Policy #:____________________

N.J. Tax Number: ______________________________

Driver License #:_________________________ State: _____ Plate #:_______________

Use Of Space (please check): Product Description:

_____Crafts/Novelties ________________________________________

_____Display Only ________________________________________

_____Food ________________________________________

(Note: Food Items Require Price List)

Make Checks Payable To: UCCA NJ-Festival Contacts: Slava Wasylak 908-925-0553 / SWasylak@aol.com Marika Bokalo 908-851-0617 / trypillian@trypillian.com

Please Send Slava Wasylak This Form to: 215 Richford Terrace Linden, NJ 07036

Internal Use:

Amount Paid: ____________________ Date: ____________________ Check #: ____________________