Bacon & Brew Bash Vendor Form

Business name

Primary Contact

Business Phone

Mobile Phone

Multi-line address

Country/Region

Address

City

Zip / Postal code

Email

If you have a Placer County health permit #, list it here.

Please confirm your understanding that food and beverage items for this event are fully donated. A modest stipend is available upon request and will be distributed following the conclusion of the event.

What type of food/beverage are you providing?

Non-alcohol Beverage (up to $100 stipend)

Alcohol Beverage (up to $100 stipend)

Appetizer (up to $150 stipend)

Main course (up to $200 stipend)

Dessert (up to $100 stipend)

What beverage/food will you be providing?

Special Requests (if you have a request, please let us know)

Electricity is extremely limited - do you require electricity for food/beverage service?

Please email your logo to rosevillepal110@gmail.com

Date

Month

Day

Year

Signature

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