VENDOR APPLICATION
The Center | Arlene Cooper Community Health Center 401 s MARYLAND PARKWAY, LAS VEGAS NV 89101 PH: (702) 733-9800 FX: (702) 733-9075
Name of Vendor:
Type of Merchandise:
Description of Merchandise/Information to Be Displayed:
Vendor Point of Contact:
First Name
Last Name
Vendor Contact Email:
example@example.com
Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Vendor Contact Phone #:
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Format: (000) 000-0000.
Vendor Fax #:
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Format: (000) 000-0000.
Number of Tables Requested:
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Power Required (YES/NO)?
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