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Israel's Youth Got Talent Vendor Application Form
PAYMENT AND APPLICATION DUE ON OR BEFORE
APRIL 27TH
MAKE ALL CHECKS OR MONEY ORDERS PAYABLE TO: SICIA Youth Outreach Program
Zelle:
youthoutreach@siciayop.org
Cashapp
: $SupremeYOP MARK ALL PAYMENTS – YOUTH TALENT SHOW 2024
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COMPANY / FIRM NAME as shown on Federal Tax Return
Your answer
VENDOR ID. if applicable
Your answer
ALTERNATE NAME if applicable / (doing business as)
Your answer
TAX ID NUMBER FEIN OR SSN
Your answer
CONTACT NAME
Your answer
YOUTH (18 years old or younger) or ADULT
Your answer
VENDOR ADDRESS
Your answer
PAYMENT ADDRESS (if different from address above)
Your answer
PHONE
Your answer
VENDOR EMAIL
Your answer
TAX EXEMPT? Y or N
Yes
No
Clear selection
ORGANIZATION TYPE
Corporation
LLC
Individual / Sole Proprietor
Partnership / Limited Partnership
Joint Venture
Non-Profit
Other:
Clear selection
FORM OF PAYMENT
Cash
Credit Card
Zelle
Paypal
CashApp
Venmo
Other:
Clear selection
1Other Payment Information/Notes
Your answer
DATE REQUESTED / SENT
MM
/
DD
/
YYYY
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