Membership

Select a membership type: *

Your Donation Amount: *

Sponsor a Small Market - $35 each:

Do you want to purchase annual insurance with the membership?

Yes - $230.99 ($35 Admin Fee + $195.99 Insurance)

Do you want to purchase annual insurance with the membership?

How would you like to pay?

Coupon:

Email: *

Address 1: *

Phone: *

Address 2:

Website:

City: *

Facebook:

State: *

Instagram:

Zip Code: *

Name (first and last): *

Phone: *

Email: *

Email (please re-enter): *

Address 1: *

Address 2:

City: *

State: *

Zip Code: *

County Located: *

Year Market Started: *

Average Number of Vendors Per Event: *

Number of Events Per Year: *

Describe your market activities, types of vendors, etc: *

Describe any past insurance claims: *

Please list any additional markets, locations, days & hours open: *

List complete name & addresses of any Additional Insureds you need listed on your Certificate of Insurance: *

Type authorized representative name for electronic signature: *

Please double-check your information above. Once you move on to the next page you can no longer make changes.