Lawrence County Senior Expo

This information is for the Program Booklet

Organization Name(Required)

Organization Mailing Address(Required)

Street Address Address Line 2 City State ZIP Code

Organization Phone(Required)

Please use the space below to indicate the information you would like to have included in this year’s exhibitor directory. Feel free to include your organization’s mission statement, available services, contact info, etc.(Required)

Exhibitor's Name(Required)

Email (Used for Confirmation)(Required)

Enter Email Confirm Email

Exhibitor Space

The information below will help us determine your needs for your space.

If you require more than the two CHAIRS that are provided, how many TOTAL chairs do you need?

Please tell us how many chairs you need for your exhibit, 2 are provided, if you need 4, please tell us 4.

If you require more than the one TABLE that is provided, how many TOTAL tables do you need?

Please tell us how many tables you need for your exhibit, 1 is provided, if you need 2, please tell us 2.

Check One - My exhibit, when placed upon a table, is higher than 3 feet.(Required)

Yes
No

Is your organization willing to share a table? Please provide the name of the organization you are willing to share a table.

Check One - I/We will require an electrical outlet. (Limited availability)(Required)

Yes
No

My organization specializes in helping Veterans and their families.

Yes
No

Check One - This organization is a non-profit (501c3) or governmental agency(Required)

Yes
No

If you selected no above, please select level of sponsorship below.

Level 1 Sponsor ($500)
Level 2 Sponsor ($250-$499)
Level 3 Sponsor ($100-$249)

I/We will be providing a healthcare screening.

Yes
No

If Yes, describe health screening.

Phone

This field is for validation purposes and should be left unchanged.

Lawrence County Senior Expo Registration

This information is for the Program Booklet

Exhibitor Space