Health Fair & Flu Shot Clinic Vendor Application
Thank you for your interest in participating in State Senator Cristina Castro and Elgin City Councilman Baldemar Lopez's Health Fair & Flu Shot Clinic on Saturday, Nov. 16, 2019. All vendors will receive a confirmation email at a later date to confirm registration.

The Health Fair & Flu Shot Clinic is free to all organizations and the public. Please call (847) 214-8864 with any questions or concerns.
Organization Name: *
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Contact First Name: *
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Contact Last Name: *
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Phone Number: *
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Email Address: *
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Street Address:
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City:
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Zip:
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Please include a short one to two sentence description of the organization you represent:
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Please include a short one to two sentence description of the services you will be providing:
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Please specify any special requests. All participants will be given one table and two chairs.
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