Instructions

Tell us about your organization and provide the information below with your primary contact.

Company/Organization Name *

Contact Full Name *

Primary Contact

Your Address *

Please provide your full address including city, state and zip code.

Phone *

Email *

Type of Products or Services

If you will be participating in the event with a booth, what product and/or service are you offering?

Your Company/Organization's Facebook Page and/or Website

Facebook title or URL and/or website

Raffle participation? *

Will you bring an item or basket to include in our fundraiser raffle? It's not required but much appreciated!

Yes

Do you have any questions for us?

Make sure you are a human *

For security verification, please enter any random two digit number. For example: 82

CV Registration