TPH IDD Virtual Expo Vendor Submission Form 2020

TPH IDD Virtual Expo Vendor Submission Form 2020

Please Respond by May 22, 2020
Business Owner/Contact*

First NameLast Name
Business Name*
Contact Number*

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Type of Business/Description of Services
Which category does your business fit in? (You may select more than one):

Education & WorkEncouragement & EmpowermentActivity & AdventureLiving & Community
UPON APPROVAL OF YOUR APPLICATION, A CONTRACT OUTLINING PAYMENT AMOUNTS, TERMS, AND CONDITIONS WILL BE SENT. PLEASE DO NOT SEND MONEY AT THIS TIME. THIS APPLICATION IS FOR REVIEW PURPOSES ONLY. SUBMISSION OF THIS APPLICATION DOES NOT IMPLY ACCEPTANCE FOR THE POTTER'S HOUSE SPECIAL NEEDS EXPO.

Thank you for your submission!
Should be Empty: