Barbershop Conversations Wellness Day – Vendor Registration Type of Organization Nonprofit OrganizationHealthcare ProviderMental Health ProviderEducational InstitutionSocial ServicesFaith-Based OrganizationOther Type of Organization Name of Organization * Contact Name * Contact Name First Name First Name Last Name Last Name Email * Phone * Number of Staff Attending Emergency Contact Name * Emergency Contact Name First Name First Name Last Name Last Name Emergency Phone * Relation Please describe the services or resources you will provide during the event. * What services will you be providing? (check all that apply) * Health Screening Educational Materials Giveaways Demonstrations Interactive Activities Wellness Services None OtherOther Will you be distributing promotional materials? * YesNo Do you carry General Liability Insurance? * NoYes Upload your logo. Drop a file here or click to upload Choose File Maximum file size: 516MB Website/URL When submitting this form, I acknowledge that: * I will arrive during the designated vendor setup time. I will remain for the duration of the event unless approved otherwise. I agree to maintain a professional and welcoming booth. I understand that EnVision Resolution Foundation reserves the right to approve or deny vendor participation. I will comply with all event policies and procedures. If you are approved to be a vendor, you need to bring your own tent (with 40lb weighs on each leg), table, and table covering. EnVision will supply up to 2 chairs, upon request. Submit If you are human, leave this field blank.
