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Cibola General Hospital

2018 Vendor Registration Form

SATURDAY, April 28, 2018 • 8 AM-11 AM • Grants High School
You will receive an email confirmation once you are registered.
* Your Organization
* Contact Person
* Address
* Phone Number
  Email Address
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? (Due to safety precautions we are limiting the availability of electricity to Section B, on a first-reserved basis. If you are assigned to Section B, please bring your own extension cord.)
Yes
No

If you require internet, we encourage you to bring a “hot spot” or other connecting device. The school’s use of its internet is limited for security reasons. We are working on an open Wi-Fi connection and will update you, accordingly. 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 and interact with our community. Our theme is diabetes but all health care topics are welcomed! We want to educate them in any possible way we can!
FOR MORE INFORMATION, CONTACT THE FOLLOWING:
Cynthia Tena Cynthia_Tena@cibolahospital.com Office: 505-287-5208 Cell: 505-290-1025 1016 E. Roosevelt Ave. Grants, NM 87020 Cynthia_Tena@cibolahospital.com www.cibolahospital.com