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2. IMPORTANT INFORMATION:

   In order to be considered for this juried event, please complete and submit the application and include a photo(s) of the art or craft you wish to display. Successful vendors will be notified of their selection, following which you will need to sign and submit a Waiver of Liability form and a temporary vendor license form and send them to the Town of MIddleburg with the required $50 fee (includes the temporary business license fee) in order to complete and finalize your registration.

4. Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Fax Number
18. Fine Art Exhibits (if applicable)

    1. Paintings
    2. Pottery
    3. Photography
    4. Sculpture

    Please identify the type of art that will be exhibited

20. Attachment (examples of artists work):*
22. Attachment (additional if needed)
24. Attachment (additional if needed)
28. Craft Vendors (if applicable)

    1. Candles
    2. Jewelry
    3. Wearables
    4. Gourmet Chocolates & Nuts
    5. Other

    Please identify the type of homemade craft or food you wish to display

30. Attachment (examples of homemade crafts or food
32. Attachment (examples of homemade crafts or food)
34. Attachment (examples of homemade crafts or food)
38. Fashion Show

    1. Please send me information about the Fashion Show
40. Certification
    I am hereby applying as a vendor for the Artists in Middleburg event as indicated below. I understand that this is a juried event and that submission of an application does not guarantee that I will be selected to participate. If selected, I understand that I will be required to sign and submit (1) the required Waiver of Liability form and (2) an application for a temporary business license from the Town of Middleburg, and to pay the required fees before my registration is complete and finalized.
42. Date of Event:*
44. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
46. Electronic Signature
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field