Market Holistic Practitioner with La Lighthouse at Casa de Luz

First Name *

Last Name *

Phone *

Business Name *

What name would you like listed on the website and in the shop?

Which market are you applying for? Please list date and location. *

Website URL *

City

State

Instagram URL *

Email *

Please expound on the list of Services that you offer? *

Do you have a license to practice if you are offering Massage, Chiropractic or other? *

Add your bio in 500 characters or less.

Short bio in 70 characters or less. *

Main Services, Title and Add Pricing, if no additional items place NA and 0.

Option 1
Option 2
Option 3
Option 4
Option 5

Please upload a clear headshot with a neutral background *

Thank you soul much for your application! We will email you within the next 5 business days.

YES I HAVE READ THE DOCUMENT and AGREE to the Expectations for La Lighthouse Holistic Co-Op Market’s Expectation of Vendors, Consignment Artisans, Practitioners, Speakers, Musicians and Volunteers.