Black Nurses Week Conference Exhibitor Application

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

**APPLICATIONS ARE DUE BY MAY 1, 2024**

Join us LIVE for our 3 day event as we shine a light on Black nursing excellence and empower Black nurses to excel and thrive in healthcare and entrepreneurship at the 3rd annual Black Nurses Week Conference. This year's conference theme is "Business, Health, and Wealth."

July 25 - July 29, 2024
The Mayflower Hotel, Washington, DC

To be considered as an exhibitor at the 3rd annual Black Nurses Week Conference, you'll need to complete this short application. If your application is accepted, we will send over our Exhibitor/Vendor Prospectus and Agreement for your review and signature.

The following application is due by May 1, 2024. Acceptance or declination notice will be sent by May 15, 2024. Exhibitor fees are due by June 1, 2024.

Email *

Thank you in advance for your interest in exhibiting at the 3rd annual Black Nurses Week Conference. By completing this application, you understand that if selected as an exhibitor/vendor, you will be required to pay an exhibitor/vendor fee ($1,000) and the Conference registration fee for each booth representative that attends the Black Nurses Week Conference ($999 for General Admission or $1,499 for VIP admission). Payments are for all 3 days of the event. Exhibitor booths are within the same space as the speaking engagements. *

I understand the fee structure and WILL continue with my application.

I understand the fee structure and WILL NOT continue with my application.

Enter your company name as you want it to be listed in the conference notebook. *

What is your company name as listed for business/tax purposes or the name listed on your organizing documents for the IRS (e.g., Black Nurses Week, LLC)? *

In what state is your business registered? *

What is your business website address? *

Who is your business contact person, and what is their business title? *

What is your preferred business email address? *

What is your preferred phone number? *

What is your business address, city, state and zip code? We may need to send you conference materials by mail. *

What is the product or service that you will be exhibiting at your booth and what benefit will your product or service provide for the attendees of the Black Nurses Week Conference? *

List all exhibitor/vendor representatives from your company or organization who will be in attendance. (First and last name.) *

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Black Nurse Week.

Does this form look suspicious? Report

Forms