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Cibola General Hospital Logo

2017 Vendor Registration Form

SATURDAY, April 29, 2017 • 8 AM-11 AM • Grants High School
You will receive an email confirmation once you are registered.
FOR MORE INFORMATION, CONTACT THE FOLLOWING:
Cynthia Tena
Cibola General Hospital Cell: 505-290-1025
Fax: 505-287-5208
1016 E. Roosevelt Ave. Grants, NM 87020 Cynthia_Tena@cibolahospital.com
* Your Organization
* Contact Person
  Profession/Title
* Phone
* Email
Closer to the date, Cynthia will reach out to you via email to follow up.
WHAT ARE YOUR BOOTH/SPACE REQUIREMENTS
* Do you require electricity?
(If possible, if you require electricity, please bring an extension cord)
Yes
No
* Do you require Internet access?
(Note: In the past Internet connectivity has been limited)
Yes
No
Each Vendor will receive one table and two chairs, upon set up more chairs will be available if needed.
* YOUR PRESENTATION/EXHIBIT WILL BE
(List basic demonstrations, tests, procedures, types of materials, etc.) This year we are asking vendors to get creative in interacting with our community. We want to educate them in any possible way we can!