Quartzsite Gold,Treasure & Craft Show
2021 Application
Friday, Saturday & Sunday February 12-14, 2021
PO BOX 4051 QUARTZSITE, AZ 85359
651-587-6136
QuartzsiteAZGoldShow.com
QuartzsiteAZGoldShow@gmail.com
Name: _________________________________________
Email:__________________________________________
Phone #:_______________________________________
Address:________________________________________
City:____________________________State, Zip:__________________________
Number In Party___________
Spaces Required:
| Indoor: $125 per 10′ x spaces desired ______ = $________ |
| Covered Outdoor: $50 per 10′ x spaces desired ______ = $________ |
| Outdoor: $50 large x spaces desired ______ = $________ |
Dry Camping space needed: yes ______ no ______
Arrival Date: _______
Required Quartzsite Vendor Permit Number:______________________
Required Arizona Sales Tax Number:_______________________________
Your Signature:___________________________________ Date:__________________
Paid with: Cash:$________ Check:$_______ Credit Card:$________
quartzsitegoldshowcom 