Your Health Matters!

Join us for a ‘Community Conversation on Preventing Mental Health Disorders and Substance Abuse in Young Women’

Thurs., Nov. 10, 2016

5:30 PM – 7:30 PM

Abate Elementary School

1625 Lockport St., Niagara Falls, NY 14305

Light refreshments will be provided!

logos-10-15-16-300x132

Vendor Registration Form

Description of Event: Niagara Falls Community Conversation on Preventing Mental Health Disorders and Substance Abuse in Young Women’

Thurs., Nov. 10, 2016 from 5:30 PM -7:30 PM Abate Elementary School, 1625 Lockport Street, Niagara Falls NY 14305

• Free Admission

Community Conversation Information and Requirements:

• Booth space fees: Free

• Application Deadline is Nov. 2, 2016

• All vendor location requests will be considered on a first come – first serve basis and honored whenever possible.

• One standard rectangle table will be provided.

• Please provide a detailed description of your booth items on the form (attach an additional sheet if necessary) and, if possible, attach photos of sample items.

• All vendors must check-in between 4:30 PM – 5:00 PM

The vendor is responsible for leaving the vendor area in the condition that it was originally received, i.e. removal of all debris such as boxes and trash.

Vendor Name:

Contact:

Address:

City:

State:

Zip:

E-mail:

Phone(s):

Type of Booth & Description:

Please indicate type and provide description,  

Please return by Nov. 2 to: kbackey@millenniumcc.org

Kimberly Backey, Project Manager Millennium Collaborative Care, PPS

1461 Kensington Ave. Buffalo, New York 14215

Office: 716-898-6423 Office Cell: 716-270-3029

www.millenniumcc.org

Follow Millennium Collaborative Care on Twitter @MillenniumCCPPS

Share

Add Comment

Your email address will not be published. Required fields are marked *

ECMC logo

The Erie County Medical Center Corporation (ECMCC) is the parent organization of Millennium Collaborative Care

Millennium Collaborative Care

1461 Kensington Ave
Buffalo, NY, 14215

t:  716-898-4950
www.millenniumcc.org

© Millennium Collaborative Care.