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VENDOR Registration Form
Westmoreland Drug and Alcohol Prevention Conference
October 1, 2021
8:30 AM to 3:00 PM
Westmoreland County Community College-Student Achievement Center
Vendor Registration is $25.
This includes table set-up and lunch.
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Email
(Required.)
*
4.
Contact Number
(Required.)
*
5.
How many people will be working at your table? (Please note, this number will be used for lunch count.)
(Required.)
1
2
3
4
5
*
6.
Are you a CSAY member or Presenter at the Conference?
(Required.)
Yes
No
*
7.
Name of your business, organization or agency
(Required.)