Black Business Exposition Interest Form
APRIL 11, 2026| 10AM-6PM| HENDERSON STATE UNIVERSITY| ARKADELPHIA, AR
Contact Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Business/Organization Information
Name of Business/ Organization
*
Owner/ Manager
*
Location
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Is this a Food Truck?
*
Please Select
Yes
No
Would you like to donate an item or service from your business to be included in our silent auction?
*
Please Select
Yes
No
If you answered "YES" to the previous question, please specify the item or service that. you will be providing.
My Products
prev
next
( X )
Sign-up Fee (Merchandise or Donations)
$
52.32
Select this option if you DO plan on selling merchandise or taking up donations. ($50.00 + Receiving Fee)
Sign-up Free (NO Merchandise)
$
26.41
Select this option if you do NOT plan on selling merchandise or taking up donations. ($25.00 + Receiving Fee)
Total
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Buy with
Submit
Should be Empty: