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Panama Canal Society, Inc.
15131 Ogden Loop
Odessa, FL 33556

On-Line Reunion Vendor Application


This form is provided for your convenience to apply to be a vendor with the Panama Canal Society, Inc.

Vendor Information
Full Name:*
A value is required.
Mailing Address:*
A value is required.
Address Cont:
City:*
A value is required.
State/Province:*
Please select an item.
Zip/ Postal:*
A value is required.
Country:*
A value is required.
Home Phone Number:*
Email:*
A value is required.Invalid format.
Types of items selling:*
A value is required.
I agree to donate a gift as a door prize for the Annual Business Meeting:
Please select an item.
If available, I am interested in paying for an additional table (only one additional table can be requested), at a cost of $50.00.
Please select an item.
   

 VENDORS MUST ORDER AND PAY FOR ELECTRICAL INSTALLATION IF ELECTRICITY IS REQUIRED. (See Vendor Instructions)

 VENDOR TABLE MAY NOT BE SHARED WITHOUT PRIOR APPROVAL. VENDORS MAY NOT TRANSFER TABLE RESERVATION TO OTHER MEMBERS OR NON-MEMBERS.

 THE HOTEL DOES NOT ALLOW ATTACHING ANY ITEMS TO THE WALL. ANY DISPLAY PANELS OR SCREENS MUST BE FREE STANDING.

 ONLY PANAMA / CANAL ZONE RELATED ITEMS ARE TO OFFERED FOR SALE.

 A PARKING FEE OF $25.00 PER DAY WILL BE PAID BY VENDORS NOT STAYING AT THE ROSEN SHINGLE CREEK RESORT. THERE ARE NO EXEPTIONS OR WAIVERS.

Please provide the following billing information: Please enter your credit card information carefully. Vendor fee is $100 


Payment Information
Card Type:* Please select an item.
Card Number:* A value is required.Invalid format.Exceeded maximum number of characters.Minimum number of characters not met. (No Dashes)
Expiration Date:* A value is required.Minimum number of characters not met.Exceeded maximum number of characters. (MM/YY)
CSV Number: A value is required.Exceeded maximum number of characters.

Please review and insure all information is correct before clicking on the Submit Form button.  Only click the Submit Form button once.  It may take a moment to send your information. Once your information is sent, you will be taken back to the On-Line Services Index page.

If you have any problems with this form, please contact the .



Process
If you are not redirected to a confirmation page after pressing submit please review the form and make sure that there are no red forms. If there is a red form please correct the information in the form so it will be satisfied.