Vendor Participation Form Vendor Participation Brand or Store Name*Primary Contact* First Last Primary Contact Email* Enter Email Confirm Email Primary Contact Phone*Brand or Store URL* Most Prominent Brand or Store Social HandleBrand or Store Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Describe the type of merchandise you would potentially present at Wine Women & Shoes*Desired Event City(s) and State(s)*LogoAccepted file types: jpg, png, pdf, Max. file size: 24 MB.I am Interested in Becoming a National Vendor Yes No I undertand I am responsible for providing merchandise and staff should I be selected as a vendor* Agree Don't Agree I agree to donate one item of $150 in value or more and 20% of event day sales to the host non-potift* Agree Don't Agree