Watts Summer Festival
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Social Service Application
Date _____________________

Agency Name _____________________________________________________________________

Address __________________________________________________________________________

City __________________________________________ State ______ Zip _____________________

Phone _____________________ Fax ____________________ E-Mail ________________________


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Space Rentals (for three days) includes one table and two chairs. Fee: $150.00

Authorized Signature __________________________________________ Date __________________

Date Paid ______________________

Method of Payment: ( _ ) Business Check ( _ ) Money Order ( _ ) Cashier's Check

Booth # ___________

APPROVED: _________________________________________________
Date _________________
Watts Summer Festival, Inc.
944 W. 53rd Street
Los Angeles, CA 90037
(323)789-7304 - Fax (323)789-5652
E-Mail: watts2k@pacbell.net
Description of Services To Be Provided
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Social Service Application