Chocolate Celebration Vendor Registration

DATE: 05/07/2021

For event details, check out the main Chocolate Celebration event page!

Contact us at (765) 453-7611 with any questions. Complete the participation agreement form below to print off and mail or, register online below.

Chocolate Vendor Guidelines 2021
Chocolate Vendor Agreement 2021

REGISTRATION AND MONEY MUST BE RECEIVED BY April 26, 2021, 4PM.

You will be contacted later in the year to finalize what “chocolate” item/items you will be featuring at your booth.

Registration

Business Name
*
Contact Name
*
Mailing Address
*
City
*
State
*
Zip Code
*
Phone
*
Email
*
1 table ($40)
*
Cost ($40 for single table)
*
Electricity Needed
Yes No
*I would like to reserve a vendor table/tables at Chocolate Celebration.
E-Signature (Please type name below to confirm)
*

Payment Information

Pay online with the form below or download/mail this form with payment to:
Samaritan Caregivers, 2705 S Berkley Rd, Suite 3C, Kokomo, IN 46902

Payment Amount
*
Name of Cardholder
*
Card Type
*
Credit Card Number
*
CVV (Digits on back of card)
*
Expiration
*

Contact Information

First Name
*
Last Name
*
Email
*
Phone
*

Billing Address

Street
*
City
*
State
*
Zip Code
*

Type the letters from the image.
*