Vendor Registration | 11th Annual Minority Men’s Health Fair

Please read the following before registering:
Space at the fair is limited and all applicants may not be accepted. We apologize for any inconvenience. Additionally, our goal is to provide health information to attendees, therefore all health organizations will be considered for space first.

* First Name:

* Last Name:

* Company Name or Cleveland Clinic Department:

* Street Address:

Street Address 2:

* City:

* State:

* Zip:

* Phone Number:

- -

* Email Address:

* Are you a non-profit organization?
Yes No

* What information, if any, will you provide at the fair:

* What screening, if any, will you provide?

Attention Cleveland Clinic departments:
If you have special requests (i.e., multiple tables, additional chairs, etc.,), please specify. Please note that every effort will be made to accommodate all reasonable requests. If unable to accommodate your request, you will be notified. Thank you.

* Will you require an electrical outlet for a display/equipment?

(NOTE: Access to an electrical outlet is not guaranteed. We will try our best to accommodate your needs. All cabling/extension cord needs are the responsibility of the attending department/organization.)

Yes No

We value your privacy.

( * ) required fields