Vendor Sponsorship Application What’s Next: Exploring your Medicare & Healthcare Options October 2024 Click here for event details Vendor Sponsorship Application Medicare Options 2024 Organization or Company(Required) Name(Required) First Last Phone(Required)Email(Required) Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Information about your business/organization and a description of what you will be distributing:Do you require an electrical outlet?If so, please bring an extension cord. Yes No Are you willing to donate an item to the Senior Center for a door prize? Yes No Vendor set-up will be between 9:15 and 9:55 a.m. The events will run from 10:00am to 2:00pm. Your registration includes: ◼ One table & two chairs ◼ Opportunity to connect with those seeking your resources and services ◼ Advertising of the events through Whatcom County’s senior centers, online event calendars, and flyers. I will not hold the Senior Centers, Whatcom Council on Aging, or Whatcom County Parks Dept. responsible for any loss or damages that may occur. The senior centers reserve the right to remove any inappropriate items. Select dates/locations October 4th, Bellingham October 11th, Blaine October 18th, Lynden October 25th, Ferndale Please choose how you would like to pay(Required) I would like to pay with credit card I would like to be invoiced Vendor Table @ $150/event Vendor Table, non-profit rate @ $50/event All events @ $400 All events, non-profit rate @ $130 Vendor Table @ $150/event Quantity Price: $150.00 Quantity Vendor Table, non-profit rate @ $50/event Quantity Price: $50.00 Quantity All events @ $400 Quantity Price: $400.00 Quantity All events, non-profit rate @ $130 Quantity Price: $130.00 Quantity Total Billing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Credit CardCard Details Cardholder Name Total
