HF Exhibitor Registration Form

*Name of Company or Organization

*Address

*City

*State

*Zip

*Contact Person

*Phone Number

*Email Address

For your exhibit, do you need:

Additional Tables
Additional Chairs
Electricity (Note: extension cords are not provided)

Please provide details for any of the above questions.

*Will you be offering a door prize?

Yes
No

*Please briefly describe your exhibit features (educational materials, screenings, demonstrations, etc.)

Will there be additional representatives for your company or organization at the Health Fair? (If yes, please include names)

*Enter Code Displayed (Security)

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