Vendor Application - Weekend of Fear

Vendor Application

* indicated required field

Company Name: *
Contact Name: *
Phone Number: *
Email Address:
Web Site:
Mailing Address:
State:  Zip:  

NJ Sales Tax License Number: *

Number of Tables/spaces Requested: *

You must discuss your request with the staff PRIOR to placing your order.  If you haven't already,  please contact

Description of Company and Merchandise:

Table or Space:


I have read and agree to the Vendor Information: *   I AGREE

Mail this form along with your check or money order (US dollars only)
$175 per table/space if purchased by July 15.  $225 after 7/15/18 to:

Mr Hush LLC
1114 Texas Palmyra Hwy, Suite 144
Honesdale, PA 18431