Veteran Expo Vendor Registration

Questions should be directed to LGRIFFITH1@PAHOUSE.NET or by calling 570.894.7905. Vendor arrival and setup time is from 9:00 a.m. to 10:00 a.m.

Agency/Business: *

Full Name:* First Name:*

Last Name:*

Email Address: *Email: *

Phone Number: *

Address: *

Fax:

Name of staffer at event (if different than Point of Contact listed above)

Do you require any special needs for your display? (If yes, please specify) *

Yes No

Comments:

Vendors are invited, but not required, to donate a door prize to be offered at the conclusion of the event. Will your organization be participating in the door prize donation? *

Yes No