Print the Application Form

Vendor Application Form
Polynesian Culture Association, Inc

Name
  
Street Address
 
City
  
State
  
Zip Code
 
Phone Number
 
E-mail:
  

 

Describe Your Product or Service
 
 
I hereby acknowledge that I have read the rules and
regulations for vendors and abide by them.
I understand that neither Polynesian Culture Associataion, Inc.
Are not responsible for any loss or damage of property,
personal injury nor will the vendors be a party to any legal
action taken against them, Owners have the right to reject
any vendors for any reason.

Signature______________________

Date____________________Amount Enclosed $______

 

 

Print the Application Form,

fill in the information requested and mail
the completed form and a check to...

Please make the check out to:
Polynesian Culture Association, Inc.

4491 NW 19 Ave
Oakland Park, FL 33309