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Application For Space



Date:
Contact Name: DBA:
Are you a sole proprietor?
Legal Company Name:
Address:
Phone Numbers:
(Must have two contact numbers - Cell # - Home # - Work #)
Fax Number: Email Address:
Name of Financial Institution:
Address of Financial Institution:
Phone No:
Term of lease requested: through
Applying for: In-line SQFT:
Describe your merchandise or service:
Price range of these items? From: $ To: $
How will merchandise be displayed (no grid will be accepted)?

Please note: This application is for information purposes only and is not to be construed in any way as a commitment to enter into a License Agreement. Vendors are chosen based on space availability and merchandise.

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