VENDOR TABLE REGISTRATION

Contacts for vendor table rental:

Prophetess Yolanda Sherman

Chief Executive Officer/Founder

Kiosha HunterChief Financial Officer

(713) 283-2446
Email: hunterkd11@gmail.com

Prophet Terrence Williams

Chief Operating Officer

Brittany MackAdministrator
(832) 752-6182
Email: bltaylor1210@gmail.com
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Company Information
Company Name _________________________________

Company Address _____________________________________

Email Address _________________________________

City ________________________________

Contact Person _________________________________

State ______________________ Zip Code ___________________

Email Address _________________________________

Business Phone ________________ Cell Phone _______________

Total Cost

______ Check ______ Card

$ _______________

______ Cash

Credit Card CC# ____________________________ CCV: __________

Card Type: Visa/MC/AE

I authorize payment via Credit Card: (Sign Here) _____________________________________

Contract must be
received no later
than June 1, 2016
NO REFUNDS

Send form to: BreakFree Release Ministries International430 Hwy 6 Ste 206 Houston, TX 77079
Vendor Table Fee includes: Table Dcor, Seating and ID Sign