Vendor App Testing

General Information

Name

Comments:

I accept the terms above and have read the Rules and Regulations of the Lafayette Market.
YesNo

Signed electronically by typing name below:

Today's Date (Please format YYYY-MM-DD, Example: 2019-01-30)

Please leave this field empty.

[wpcontacts] wpfieldmap=your-name:first_name wpfieldmap=comments:extra_column_37 wpfieldmap=signature:extra_column_35 wpfieldmap=signature-date:extra_column_34 extra_column_36="Yes" extra_column_16=New Entry owned_by=Mike Bass l_source=Online Form l_status=Pending l_type=Vendor wpdatabasemap=Vendors [/wpcontacts]