* Name

* Email

* Business Name

* Address

* City/State/Zip

* Phone

URL

* Please describe your product and what you will be selling:

* Where can we find photos of your products? If not online please submit to info@rockandshopmarket.com

Upload Your Logo

Which event(s) are you applying for? Rock & Shop Market - Saturday December 17 2011 - Durham

* Do you plan on splitting a table? Yes
No

* Are you Interested in submitting products for the raffle gift basket? Yes
No

* How are you paying? Check
Paypal

How did you hear about the market?

What advertising suggestions do you have towards promoting the event?

* What vendors and bands would you like to see at the next event:

* Neither Michelle Smith, The Rock & Shop Market, or any of the venues: Motorco Music Hall, Fullsteam Brewery or The Trotter Building will be liable in any way for lost merchandise, display or merchandise damage or personal injury. Agree

* Verify