Unlocking Stigma 2017 Vendor Registration Form
The Norooz Clinic Foundation's Unlocking Stigma 2017
Event Timing: January 24, 2016 from 11:00 AM to 4:00 PM
Event Address: University of California, Irvine

Booth Registration: FREE
REGISTRATION DEADLINE: January 17, 2016

APPLICATION IS CLOSED, AT MAX CAPACITY

Name of Organization *
Your answer
Brief Description of Organization *
Your answer
Featured Activity at Booth *
Your answer
Name of Contact *
Your answer
Email *
Your answer
Phone Number *
Your answer
Organization Website
Your answer
Event Contact Info:
Nina Huynh
Executive Director, Youth Program
CAPFair Event Coordinator
The Norooz Clinic Foundation
nhuynh@noroozclinic.com
714.272.9996
www.noroozclinic.com
202 Fashion Lane, Suite 219, Tustin, CA 92780
Funded By:
Orange County Health Care Agency (OCHCA), Behavioral Health Services, Prevention & Intervention, Mental Health Services ACT/Prop 63
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms