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APPLICATION FORM |
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NAME: ___________________________________ E-mail: _________________________________ ADDRESS:_________________________________________________________________________ POSTAL CODE:_____________ PHONE:(____)________________ FAX:(____)__________________ FOODS TO BE SOLD:________________________________________________________________ ATTENDING THURSDAY EVENING?: YES NO PLEASE INDICATE IF YOU WISH SAME LOCATION AS LAST YEAR ______ BEER GARDEN (includes hydro) - $400 FOOT FRONTAGE REQUIRED (must include trailer hitch and any additional trailers required for storage or accommodations) |
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____________ X $15 = _______________ HYDRO REQUIRED (must include requirements for storage/accommodation trailers) ____ 15 AMP 120 VOLT - $20 = ________________ ____ 20 AMP 240 VOLT - $30 = ________________ ____ 30 AMP 240 VOLT - $45 = ________________ ____ 40 AMP 240 VOLT - $75 = ________________ ____ 60 AMP 240 VOLT - $120 = ________________
TOTAL = ________________ |
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Questions
regarding this application and the location of concession spaces should be
directed to Gerry Wever at 445-0904 or Beth Ruiter at 445-5744. SIGNATURE: ________________________________________ DATE: ______________________Enclosed: ____ Payment ____ $2,000,000 Certificate of Insurance naming the Russell Agricultural Society as an additional insured ____ Photograph of concession (if new concession) Return applications, Certificate of Insurance and photograph to Russell Agricultural Society, P.O. Box 730, Russell, ON K4R 1E5.
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