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"*" indicates required fields

NOTE: All vendors must provide a service to low income and/or homeless individuals. NO SELLING WILL BE PERMITTED.

Event Name*

Contact:*

Location:

Date Of Event:*

Time:

Organization:*

Type of Organization:*

Nonprofit

Business

Address:*

Street Address City State ZIP Code

Phone:*

Email:*

Fax:

How Many Representatives Are Attending?*

Representative #1 Name*

First Last

Representative #1 Phone*

Representative #1 Email*

Representative #2 Name*

First Last

Representative #2 Phone*

Representative #2 Email*

Representative #3 Name*

First Last

Representative #3 Phone*

Representative #3 Email*

Representative #4 Name*

First Last

Representative #4 Phone*

Representative #4 Email*

Representative #5 Name*

First Last

Representative #5 Phone

Representative #6 Name*

First Last

Representative #6 Phone

Representative #7 Name*

First Last

Representative #8 Phone

Representative #8 Name*

First Last

Representative #7 Phone

Tables Needed:*

Chairs Needed:*

Nature of Materials and/or Information to be Provided:*

Special Accommodations:*

*Tables and chairs will be provided at this event. This is an outdoor event; it is recommended that all resource providers bring a canopy.

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Would you like to contribute a raffle prize to the event?*

Yes

Description and Quantity:

Vendor Participation Application

Volunteer

Donate

Sponsor