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EVENT LISTING APPLICATION
YOUR DETAILS * Required Fields Show on Listing?
*Your Name: Phone:
*Email: Mobile:
Business Name: Fax:
City:      
State: Post Code:      
ABOUT YOUR EVENT
EVENT Name:
Location Line 1:
Location Line 2:
City:
    
State:
 PostCode    
Map Reference:
 e.g. Melway 67-G4, Sydney UBD 220-F4
Area
 e.g. Hunter Valley, Melbourne South 
YOUR EVENT CONTACT DETAILS
Contact 1:
Contact 1 Phone:
Contact 2:
Contact 2 Phone:
Phone Enquiries:
  
Info Line:
Fax:
Website: 
Event Email:
Postal Address:
 
YOUR EVENT DATE(S)
Start Date:
End Date:
Hours From:
 To:
Setup From:
    
Number of Stalls at the Event:
Stall Fee From $
I would like an optional on-line stallholders application form (Extra $95.00)
Please describe your event:
SOCIAL NETWORKING
Blog
 Blog
Enter the web address of your blog
Facebook
 Facebook
Add your Facebook Profile ID
MSN
 MSN
Add your contact email sddress
Twitter
 Twitter
Enter your Goodies Button address
Skype
 Skype
Enter your Skype Name
  Other
Enter Link Details
PAYMENT OPTIONS (FEE $55.00) plus (Option) On-line Application form (Fee $95.00)
By Funds Transfer: To Market Stallholders Register BSB 062-572 Account No 10093608
By Cheque: The Market Stallholders Register. PO Box 407 Picton NSW 2571
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Contact The Register on 02 4683 3778 or 0438 898 221
email admin@stallholders.com.au
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