ENTRY FORM

Please print (Entry form must be received by November 12, 2007).



Name:______________________________________________________________________________________


Company:___________________________________________________________________________________


Mailing Address:______________________________________________________________________________


City:___________________________________________ State:___________ Zip:______________


Phone: (Business):_____________________________ (Home):________________________________________


Description of items to be Sold: __________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________


Number of 8' X 8' Spaces needed at a cost of $45.00 per space.________ Total enclosed $__________


Electricity needed:____________ Table needed:___________Other needs:________________________________



Please make check payable to: UW Geological Museum.

I have read the attached information and agree, if accepted as an exhibitor, to abide by all decisions and regulations of the 2007 Brontosaurus Holiday Bazaar. I agree to abide by all laws and ordinances of the City of Laramie and Albany County. I agree to not hold responsible The UW Geological Museum, Albany County Fairgrounds, or any of the organizers, sponsors or co-sponsors of the "Brontosaurus Holiday Bazaar" for any theft, loss or damage to my merchandise/property, or bodily injury. I also give permission for the free use of my name and/or picture in any account of this event.

Signature:___________________________________________

Date:_______________________________________________

Contact: Brent Breithaupt, Brontosaurus Holiday Bazaar, Geological Museum, Dept. 3006, 1000 E. University Ave., Laramie, WY 82071. Please direct any questions to: Brent Breithaupt, 307-766-2646 or uwgeoms@uwyo.edu

For Application Confirmation please send a self-addressed stamped envelope.