Legacy Exhibitor Registration Form
"A Legacy Revealed | Champions of Justice" Black History Celebration
Thursday, February 21, 2019
Event Set Up: 4:30 pm - 5:30 pm
Interactive Exhibit: 6:00 - 7:00 pm
Legacy Showcase: 7:00 pm - 8:30 pm
Event Address: Mark Twain House & Museum, 351 Farmington Avenue, Hartford, CT
Contact : Kyrinda Richardson (860) 728-4291 or krichardson@ulgh.org
Organization Name
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Contact Name *
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Email Address *
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Phone Number *
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Mailing Address
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Brief description or type of table
(ie. interactive activity, informative materials, historical cultural display, books, pamphlets, artifacts, community resources, digital display, etc.)
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Special Needs (Table & Cloth provided)
Exhibitor Duration
Total number of team members attending
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Additional questions/concerns for event coordinator?
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I understand this is a free event, and exhibitors (vendors) are not permitted to sell items to attendees. *
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