Business Name
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Primary Contact Person
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Primary Contact Telephone
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Primary Contact Fax
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Primary Contact Cell
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Primary Contact Email
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Secondary Contact Person
Secondary Contact Telephone
Secondary Contact Celll
Secondary Contact Email
Business Website
Business Address
Business City
Business State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Business Zip
Seller's Permit Number
Tax ID Number
PCI Pageant EXPO's Sales Agent's Name
Type of items to be sold or displayed: if accessory, what type of accessory
Type of items to be sold or displayed: if clothing, what type of category
Type of items to be sold or displayed: if informational, what type of information displayed
Type of items to be sold or displayed: if other, list items for sale (designers, items) and include the price range of items you will be bringing
Please provide a brief description of your business
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Please sign to indicate you have read all the information and conditions in the VENDOR INFORMATION package.
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Vendor Packages
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Early Bird - Before 6/15 ($125 USD)
Regular - Before 7/5 ($175 USD)
Late - After 7/5 ($200 USD)
Stage Presentation & 8 VIP tickets ($250 USD)
Make-up Artists & Hairstylists Presentations& 10 VIP tickets ($250 USD)
Products Display on Stage & 10 VIP tickets ($300 USD)
Major Showcase Vendors & 20 VIP tickets. ($500 USD)
Logo and Link on PCICulture.com for 1 year ($100 USD)
Non-vendor's logo and Link on PCICulture.com for 1 year ($200 USD)
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