Retail/Service Vendor Application (Westfield Rocks the 4th)

2. Business or Group Name*
4. Business Address*
6. City*
7. State*
8. Postal / Zip Code*
10. Website*

    If you don't have a website, please put N/A.

12. Main Contact First Name*

    If your day-of-event contact person will be different, please add their contact information in the additional comments field below.

13. Main Contact Last Name*
15. Main Contact Phone Number*
17. Main Contact Email Address*
19. RETAIL VENDORS ONLY: Products or Menu List*

    Please include the pricing of all products you plan to sell. 

    If you are a Service Vendor, please put N/A

21. SERVICE VENDORS ONLY: Please list all items you will be bringing to the event*

    Ex: giveaway items, marketing materials, etc.

    Please note that disposable water bottles are not an acceptable giveaway item. 

    If you are a Retail Vendor, please put N/A

23. Vendor Booth Type*

    1. 10' x 10' Booth: $125
    2. 10' x 20' Booth: $250

    All Retail/Service Vendors will be placed under a large tent.

25. Set-Up Time Needed*

    1. 30 minutes
    2. 1 hour
    3. 1.5 hours
    4. 2 hours
    5. 3 hours
27. Will you need Westfield Welcome to provide electricity on July 4th?*

    1. Yes
    2. No

    Electricity will only be provided to those who request it by selecting "Yes," and an additional $100 electricity fee will be incurred.

29. Please indicate how much power you will need, and/or what needs to be powered at your booth.
31. Additional Comments

    Anything else the Westfield Welcome team should know?

33. I AGREE THAT I AM AVAILABLE ON THE SELECTED DATE AND I WILL HOLD THE DATE UNTIL THE STATUS OF MY APPLICATION IS CONFIRMED BY WESTFIELD WELCOME STAFF
    -- Select One --Yes
35. I AGREE TO BRING ALL OF MY OWN EQUIPMENT INCLUDING BUT NOT LIMITED TO TABLES, CHAIRS, SIGNAGE, ETC.*
    -- Select One --Yes
Leave This Blank:


37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit

* indicates a required field