2012 Vendor Pre-Registration

Pre-Register and receive a discounted rate here.
* Indicates a required field.

*First name:

*Last name:

*Email:

*Phone:

*Street Address:

*City:

*State:

*ZIP Code:

*Are you a tax exempt entity?

*Are you an active NoVA Jaycee?

*Select Dates and
Number of Spaces:

(You may choose up to 3 spaces per date.)

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