BOOTH APPLICATION FORM

NAME____________________________________________________

ADDRESS_________________________________________________

CITY/ STATE_______________________________________________

PHONE__________________________

TYPE OF MERCHANDISE_______________________________________

BOOTHS REQUIRED

_______ 10' X 10' ONE DAY - $15
_______ 10' X 10' TWO DAYS - $28
_______ 20' X 10' ONE DAY - $28
_______ 20' X 10' TWO DAYS - $50

Table Rental: $5 per table per day

NO. OF TABLES NEEDED______________

NEED ELECTRICITY? ____YES ____NO

MAKE CHECKS PAYABLE TO:

GRIFFITH HISTORICAL SOCIETY, INC.
MAILING ADDRESS: P.O. BOX 678, GRIFFITH, IN 46319

FOR INFORMATION CALL: GARY WILSON-(219) 923-4110

REGISTRATION DEADLINE: SEPT. 15, 2004

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November 26, 2004
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