| EDGE&TA Branch # |
| Name: |
| Mailing Address: |
| Business Name: |
| Mailing Address: |
| Business Phone: Business Fax: |
| Home Phone: E-Mail address: |
| Specific Description Sales: Products, Crafts or Materials |
|
| Number of persons working in booth: |
| Name of persons that will be working |
|
| Spaces are 10 x 10, how many spaces are required? |
| Number of days needed: |
| Specific requirements: Electric hookup, etc: |
|
| 10 x 10 spaces are $ per day. No refunds after date |
| Amount enclosed: $ |
Applicants Signature: Date: |
| Make Check payable and Mail to: |
| EDGE&TA Branch #: |
| Branch address: |
| Branch City/State/Zip: |
| In order to set up at our shows a certificate of liability insurance indicating general liability coverage with minimum limits of $1 million. It must name the Early Day Gas Engine & Tractor Association, Inc. and Early Day Gas Engine & Tractor Association, Inc. Branch 000 as an additional named insured. The certificate is required with this application.
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