2019 Juneteenth Vendor Registration
Event Date: Saturday, June 15, 2019
Event Address: Viola Gibson Park, Cedar Rapids, IA
Contact us at 319-862-2101, lcassell@blackiowa.org
Email address *
Registration
Please complete and submit the form. Vendor fee must be received before your registration is confirmed.
Vendor Designation *
Contact Name (first & last) *
Your answer
On-Site Representative (if different from Contact Name)
Your answer
Mailing Address (in full) *
Your answer
Contact Phone Number *
Your answer
Contact Email Address *
Your answer
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