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Registration for Jim's Pharmacy Health & Fitness Expo Vendor Registration, 2017 :


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Registration for Jim's Pharmacy Health & Fitness Expo Vendor Registration, 2017 :

* Rental fee for 8' x 8' space, skirted table and 2 chairs:
NOTE: Prices are not final and may be adjusted during the registration process.


* Business/Organization:
* First Name
* Last Name
* Phone Number
* Contact #2 First Name:
* Contact #2 Last Name:
* Contact #2 Phone Number:
Participant Address
* Address line 1
Address line 2
* City
* State
* Postal code
* Country
* Email Address
* Will you need electricity?
How many appliances?
Outlet voltage?

The following is for food vendors only:

Food and beverage items to be sold:
Are you properly licensed and permitted?
Will you comply with all State & local regulations?
* Waiver:

Initial to agree to the above waiver:  
* Waiver:


Initial to agree to the above waiver:  



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