Contact Information
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Company Name
What will you be selling?
*
Back
Next
Branding
Website URL
Instagram Social Handle
Facebook Social Handle
Logo Assets (for use on marketing promotional materials)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Tax ID #
*
Were you referred from Juniper Rag?
Yes
No
Submission Details
After submitting be on the look out for an email from Candace Casey (ccasey4@worcester.edu) to confirm details and payment information. Payments received before May 1st will be $65. Payments received after May 1st will be $75. Limited space available; first come first serve.
Submit
Should be Empty: