Vendor Request Form
Name of Requesting Agency:
Date of Event:
Time
Start Time:
Set-up Time:
Break Down Time:
Address of event
Street Address:
City:
State:
Postal/Zip Code:
Agency Contact Person
First Name:
Last Name:
Office Phone:
Cell Phone:
Example: (555) 555-5555
Fax:
Email:
Example: username@example.com
Purpose of Fair/Summit: Please provide a detailed description of the event you would like the SSA to participate in. Please describe the nature of event and targeted audience.:
How many attendees do you expect?:
What type of collateral materials would you like the SSA to provide? Please be specific in the content area.:
Please list what will be provided (table 8ft, table 6ft, number of chairs, tent):
Is there designated parking for vendors?:
Will parking passes be issued? If so, how many?:
Is there additional information you think would be helpful in preparation for this event?: