Vendor Participation Application

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

Event Name(Required)

Contact:(Required)

Location:

Date:(Required)

MM slash DD slash YYYY

Time:

Hours

:

Minutes

AM/PM

Organization:(Required)

Type of Organization:(Required)

Nonprofit

Business

Address:(Required)

Street Address City State ZIP Code

Phone:(Required)

Email:(Required)

Fax:

Number of Representatives Attending:(Required)

Names of Representatives Attending:(Required)

Contact Numbers (Onsite):(Required)

Tables Needed:(Required)

Chairs Needed:(Required)

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.

Hidden

Would you like to contribute a raffle prize to the event?(Required)

Yes

No

Description and Quantity: