Viterbo University - The University of Opportunity: Hope and Help

 

Viterbo University
Health Fair Top

2014 REGISTRATION FORM

The event will be held in the Amie L. Mathy Center on the Viterbo campus. The event will take place on Tuesday, April 8, 2014, from 2:00 p.m. to 6:00 p.m.
Set up will begin at 1:00 p.m. and teardown will begin at 6:00 p.m.

Organization:  

Contact Person:   

Address (include City and Zip Code):   

Phone Number:   

Fax Number:   

Email:   

 

Please Check One: 

Yes, I would like to confirm my participation in the Community Health Fair. I will send the $30 registration fee made payable to Viterbo University.
No, I will be unable to participate in the Community Health Fair.

 

Please give a brief description of your services/screenings/demonstrations for the Health Fair: 

 

 

Equipment: Please indicate the number of chairs and tables you will need. One table and two chairs are included with the participation fee. If more tables and chairs are needed please specify below.

Additional Tables:   One table provided, extra tables will cost $10 each.
Additional Chairs:  

Will you need a table covering to be supplied for your booth? 
 

 

Electrical Access: Will you require electrical access?  
 

Health Fair Bottom