Name……………………………………………………………

Address…………………………………………………………

………………………………………………………………….

Phone No……………………………………………………….

Email……………………………………………………………

Lines Carried………………………………………………….
(there will be a restriction on the duplication of lines)

I/we require the following to be provided (delete those not required)

Tables Chairs Electric Supply Water

I/we hereby enclose cheque for £20, being reservation fee for a stall at the market on………………….

Signed……………………………………….

Date………………..

Please detach this slip and return to
Penkridge Markets, Pinfold Lane, Penkridge, Staffs. ST19 5AP