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Sunday, April 13th, 2008

SIGN UP

Registration

The Dale City Holistic Health Fair

Sponsored by Harmony Productions

Reserve a booth for me!
Sunday, April 13th, 2008
10:00 am to 6:00 pm

Located at:
Dale City VFW
14631 Minnieville Rd
Dale City, Virginia 22193

The Cost of a booth is now $200.00

1.)

Name of Booth

No. of Booths

Your Name

Product or Services

Address

City State Zip

Phone Number

E-mail Address

Website Address

http://www.

2.)

SPECIAL NEEDS:

Electricity ($25) Extension Cord($10)
Power Strip($15) Easel($25)

3.)

DOOR PRIZES:

Yes, I would like to contribute to the Door Prize
Intended Door Prize:

4.)

WORKSHOP:

Yes, I would like to present a workshop
(Workshop availability is limited and will be issued to participants on a first come first serve basis upon receipt of a completed application and booth payment.)

Workshop Title
Please provide a written paragraph (approximately 75-100 words) on a separate piece of paper. Workshops are assigned on a first come, first serve basis. There is no charge for the workshops. Additional workshop time can be requested for $25 each (space available).

5.)

Payment Method:

Credit Card Information
Choose one: Credit Card Paypal
**Name On Card:
**Card Number (Example 3333 4444 5555 7777):

Type: Expiration: **3 Digit Code:

6.)

AGREEMENT:

I agree to have my booth staffed and intact until 6:00 pm.

7.)

AGREEMENT:

I have read the Harmony productions policy and agree to all the terms and conditions.

PAYMENT INFORMATION

The cost per booth is a non-refundable $200. Booth fees are now payable with Check, Visa, MasterCard, Discover, American Express, or Paypal. Please be sure to send your application form in early!

Checks should be made payable to:

Nancy Waltz
14213 Bremerton Drive
Dale City, VA 22193

Please feel free to contact Nancy Waltz 703-878-6699 or via cell at 703-915-3165 or Hala Ayala at 703-402-1970 if you have any questions or concerns

*Please Note: Payments must accompany your application in order to secure your booth. All payments must be post marked or received by due date. Any booth payments that are received after the posted due date will accrue a late registration fee. All application information regarding booth fees are located on the Health Fair Tab of this site.