Name *

Name

First Name

Last Name

Business Name

Website

http://

Phone *

Phone

(###)

###

####

Email Address *

Sponsorship Amount

$

Do you need a 501 C3 Tax Deductible Donation? (Please note Wakanda Market Vendors not eligible)

Yes

No

Wakanda Market Vendor- What kinds of items will you sell? Please limit to 1 -3 items do to space

Wakanda Market Vendor - Estimated Gross Sales

Wakanda Market Vendor- I acknowledge the vendor fee of 5% of Gross Sales

Yes

Payment Type

PayPal

Credit Card (fees apply)

Check

Additional info or questions