Riverpalooza: Vendor Form - River Palooza Fort Wayne

Proud Sponsor:
Riverpalooza: Vendor Form
Sponsored by the Mayors’ Youth Engagement Council
Riverpalooza – May 30th, 2015
Location: Headwaters West
Time: 9:00 a.m. - until approximately 5:00 p.m.
Our organization is interested in participating as as vendor in Riverpalooza.
$50 – Non-profits
$75 – All other vendors (This event is a fundraiser!)
**Once your form with payment is received, more information will follow**
Vendor Name:
(As you would like it to appear on any printed materials)
Type of Vendor (i.e; food, merchandise) :
Name and phone number of person to be contacted for additional information:
Name: Fax: (
Phone: (
Address: State: )
E-mail: City: Zip: ☐ Payment enclosed: $____________________ (Checks - money order or cash)
Payable to: Mayor’s Youth Engagement Council
Mail to: Karen L. Richards
200 E. Berry Street, 4th floor
Suite 420, Fort Wayne, IN 46802
** Should we fail to show on the day of the event without 5 days prior notice, we understand we will be invoiced $50.00
For additional information please see www.Riverpaloozafw.org or contact:
Karen Richards, Liaison for Mayor’s Youth Engagement Council
[email protected]
(260) 427-2146