Event Registration (Vendor & General Attendees)

EMPOWERMENT THROUGH AWARENESS

A Community's Commitment to HIV Prevention
Join ASC for an enlightening event focused on HIV Prevention and Testing! Our community is coming together to raise awareness and empower individuals to take charge of their health. This in-person event will be held at 220 S 40th Ave. Enjoy refreshments, vendors, and prizes.

Let's work together to make a difference and create a safer, healthier community for everyone. See you there!
Are you registering as a:*

Community MemberVendor
Organization:*
Point of Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Item for Raffle Submission:*

YesNo
If yes, please describe the item
Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
DISCLAIMER:

Our educational sessions last between 60-90 minutes. If you wish to request a longer time period, please reach out to us beforehand at 601-329-2425 ext. 103 or ascoutreach103@gmail.com. If you are college/university that wishes to book a 101 class for multiple classes, please reach out as well for scheduling!
Should be Empty:

EMPOWERMENT THROUGH AWARENESS