Health Fair Vendor Registration

Health Fair Vendor Registration

Register your business or organization to participate in our upcoming Health Fair. Please complete all required fields. The services rendered are free to the public.
Business/Organization Name
Contact Person Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Business Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Type of Business/Organization
Please describe the products or services you will offer at your booth.
Will you require electricity at your booth?
Will you be providing food or beverage samples?
Additional Comments or Special Requests
Signature (please sign to confirm your registration and agreement)
Should be Empty: