Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Name
*
Product or Service Offered
*
Workshop Location & Date
*
Please Select
Indianapolis – May 2nd
South Bend - June 27th
Michigan City - August 22
May 30- South Bend
Preferred Payment Method for Vendor Fee- payment due 30 days before event
*
Cash App
Zelle
Signature: I certify I will commit and make payment on time.
Stay Connected:Are you interested in joining The Balanced Wellness Circle our virtual community?
Yes, I am interested
No, thank you
Register as Vendor
Register as Vendor
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