Are you a Lewis County Resident?: Yes
Business Name: My Business
Phone Number: 606 555 1212
Address: 1212 Main Str
City: Vanceburg
State: KY
Zip Code: 41179
Email address: nunya@nunya.com
Are you currently a Lewis County Chamber of Commerce Member?: Yes
Describe products, menus, items you plan to sell or exhibit.: Basic Stuff
Radio Buttons: 20 ft Space Food Vendor $75.00
Will you Need Electricity?: Yes