Wander Ellwood

Wander Ellwood Participation Form

"*" indicates required fields

Owner/Seller Name*

Business Name*

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Products to be sold*

Are you a member of the Ellwood City Area Chamber of Commerce?*

Yes

Vendor Type - Member*

Vendor Type - Non-Member*

Food Truck license needed?*

Borough for a Transient Retail Business Permit/License is required for all Food Trucks.

Yes

Total

Credit Card*

Cardholder Name

Card Details