Request an Application

Please submit this form and we will contact you via email with the information you have requested.

To ensure that you see our response, please add vintageattheyard@gmail.com to your contact list.

Name

First Name

Last Name

Business Name

Phone

(###)

###

####

Email Address

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Description of goods being sold:

If you have a website or facebook site for your business, please add the web address here.

Do you have a seller's permit?

We do require a seller’s permit from the Board of Equalization, a temporary seller’s permit, or a signed 410D if you are an occasional seller.

Yes

No