JAZZ AT DREW
Saturday, October 1, 2016 12PM to 10PM
MARKETPLACE VENDOR APPLICATION
Booth assignments will be given on a first-come, first-pay basis. Please adhere to the following vendor application
deadlines:
Completed Vendor Application & Processing Fee Deadline… August 12, 2016
Booth Rental Fees & Proof of Insurance Deadline… September 1, 2016
*This application does not guarantee participation as a vendor. Vendors will be notified via email of their
application status.
Applicant’s Name (print or type) ____________________________________________________________________________
Business, Studio, or Company Name _________________________________________________________________________
Street Address/P.O. Box ________________________________ City___________________ State_______ Zip ____________
Phone ______________________ Email __________________________________ Website ___________________________
Contact Person during “Jazz at Drew” __________________________________ Cell _________________________________
Provide a detailed description of the kind of items you intend to show/sell:
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Have you participated in the “Jazz at Drew” Cultural Marketplace in the past? Yes____ No_____
Do you require an additional electrical hook-up?
Yes _____ No _____
*The booth includes access to electrical power up to 20 AMP Wattage (no additional charge)
Because of limited space and in order to keep diversity among our vendors, it is suggested that you submit slides and /or pictures
of your product. BRIEFLY DESCRIBE THE WORK ILLUSTRATED IN YOUR SLIDES AND/OR PICTURES BELOW:
Slide or Picture #1
________________________________________________________________________________
Slide or Picture #2
________________________________________________________________________________
Slide or Picture #3
________________________________________________________________________________
FOOD VENDORS, must obtain a Health Permit from the LA County Health Department. There will be an additional fee for health
permits, paid directly to the LA County Health Department. A MANDATORY on-site meeting with the Health Department will be
scheduled. Food Vendors must be present to receive their permit. Please come ready with a cashier check or money order.
All vendors must provide proof of general liability insurance in the amount of One Million Dollars ($1,000,000.00) or participate in
the University’s blanket insurance coverage for an additional fee of $125.00. Failure to provide proof of insurance by
September 1, 2016 will automatically place you under the University’s umbrella policy and you will be charged $125.00.
Booth Rental Fees:
 Application Processing Fee (non-refundable)……………
 Non-Food Booth(s) ………………………………...….....
 Non-Profit (Information Only) Booth(s) …………………..
 Food Booth(s) ……………………………………………..
 Dessert & Non-Alcoholic Beverage Booth(s)…………….
 Additional Electrical Hook-ups (optional) ………………..
$40.00
$350.00
$300.00
$500.00
$300.00
$40.00
*The booth includes access to electrical power up to 20 AMP Wattage no additional charge
PAYMENT IN FULL AND PROOF OF INSURANCE MUST BE RECEIVED BEFORE BOOTH
ASSIGNMENTS ARE GIVEN TO VENDORS - NO EXCEPTIONS
Payment accepted: Cashier Check, Money Order, American Express, Visa, Master Card or Discover (No Personal
Checks) Make Certified Funds/ Money Orders Payable to “Charles R. Drew University”
Credit Card Authorization: _____ AMEX _____ Visa _____ Master Card _____ Discover
Name on Card________________________________________________________
Card Number___________________ Exp. Date _______ Verification Code ______
Amount to be Charge $___________________
Authorized Signature ________________________________ Date_________________
Mail payment and completed application to:
Charles R. Drew University of Medicine and Science
“Jazz at Drew” Cultural Marketplace
1731 East 120th Street
Los Angeles, CA 90059
For More Information Please Contact: [email protected]
I understand this application does not guarantee my participation. I release Charles R. Drew University of Medicine
and Science 2016 “Jazz at Drew” and all of its duly appointed representatives of all liability and responsibility for
damages or loss suffered before, during and after the Cultural Marketplace, or as a result of the display of my work,
equipment or materials.
______________________________________
Signature
________________________
Date
For Internal Use Only
Application received__________
Booth # Assignment________