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Event Vendor Registration

2. ATTENTION: This business is not approved until payment is received and vendor permit is sent out to you.
4. Name of Special Event*
   Please type the name of the special event you will participating in.
6. Will you be participating one day or multiple days?*
   -- Select One --One DayMultiple Days
8. Which Day*
   Which Day
9. Which Days?*
   Which Days? Start Date

   —

   Which Days? End Date
11. Business or Organization*

    Business or Organization that you are affiliated with. If none type "none"

13. Contact First Name*
14. Contact Last Name*
16. Contact Address*
18. Contact City*
19. Contact State*
20. Contact Zip*
22. Contact Phone Number*
23. Contact E-Mail*
25. Business Address*
27. Business City*
28. Business State*
29. Business Zip*
31. Business Phone Number
33. Are you licensed with the City of Waukegan?*
    -- Select One --YesNo
35. Please provide Waukegan Account Number*
36. Please provide Waukegan License Number*
38. What city are you licensed in?*
40. What type of vendor will you be?*

    Check all that apply.

    1. Food
    2. Merchandise
    3. Service
    4. Informational
    5. Entertainment
Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field