39th Annual - Gifts 'n Tyme Holiday Faire
November 18, 19, & 20, 2011
APPLICATION
Name_________________________Email(clearly please)______________________________
Business Name_______________________ Website__________________________________
Phone__________________Cell Phone___________________Fax_______________________
Address_________________________City____________________State_____ Zip__________
Resale No. (Required)________________________Vehicle License No.__________________
Complete Description of Media (items not listed may not be allowed____________________
______________________________________________________________________________
My display can fit into a (Check one or two): ____9'w x 10'd ____10' x10' ____15'w x 7'd
I need electricity: _____yes ____no
I use an EZ-up or "fixed frame" Canopy: _____yes _____no (I will decorate if yes ______)
Please send me (#)_______fliers for my distribution.
Please include a #10 self-addressed, stamped envelope (with .44 postage), AND a 6" by 9"
self-addressed, stamped (with .61 postage) envelope with your application.
No. of spaces: ____
_______$390 first space
_______$370 each additional space
_______$410 - ALL pre-packaged Foods
_______Deduct $15 if you have a Napa Business License or a Veteran
License_____(required)_______DD214 enclosed? (a must)
_______Total Fees Enclosed
NOTE: PLEASE MAKE CHECKS PAYABLE TO KIM PATILLO
Past participants - do you want the same space? (we will TRY)____yes____doesn't matter
Do you need motel or directions to the show?__________yes _________no
LIABILITY CLAUSE: By my signature below, I hereby agree to hold harmless Kim & Mark Patillo, DBA After
the Gold Rush, Wanda Haycraft, Shaughn Young & District Agricultural Assn. from any loss, injury, or dam-
ages that I or anyone in my party may cause or incur while participationg in said Faire or on property of same.
Signature of Applicant________________________________Date________________________
Please send application, photos, fee, and a self-addressed, stamped envelope to:
Kim Or Mark Patillo, After the Gold Rush, P. O. Box 5171, Walnut Creek, CA 94596
We look forward to working with you all!